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Severe reversible cerebral vasoconstriction syndrome mimicking aneurysmal rupture and vasospasm

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Abstract

Introduction

Presenting symptoms of aneurysmal subarachnoid hemorrhage (SAH) and reversible cerebral vasoconstriction syndrome (RCVS) may overlap. Patients with RCVS often harbor unruptured aneurysms.

Summary of Case

We report a case of RCVS in a patient with an unruptured intracranial aneurysm. The development of diffuse vasoconstriction after aneursym clipping in the absence of any subarachnoid blood was initially confusing, until subtle vasoconstriction before clipping was seen retrospectively.

Results

We obtained perfusion and diffusion MRI studies on this patient, which shed light on the pathophysiology of RCVS.

Conclusion

It is important for physicians who care for patients with aneurysmal SAH to recognize RCVS, as the treatments for these two conditions are different.

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Authors and Affiliations

  1. Department of Neurological Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

    Christopher Nickele, Kenji Muro & Christopher C. Getch

  2. Department of Neuroradiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

    Matthew T. Walker

  3. Davee Department of Neurology and Clinical Neurological Sciences, Feinberg School of Medicine, Northwestern University, Abbott Hall 11th Floor, 710 North Lake Shore Drive, Chicago, IL, 60026, USA

    Richard A. Bernstein

Authors
  1. Christopher Nickele
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  2. Kenji Muro
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  3. Christopher C. Getch
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  4. Matthew T. Walker
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  5. Richard A. Bernstein
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Corresponding author

Correspondence to Richard A. Bernstein.

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Nickele, C., Muro, K., Getch, C.C. et al. Severe reversible cerebral vasoconstriction syndrome mimicking aneurysmal rupture and vasospasm. Neurocrit Care 7, 81–85 (2007). https://doi.org/10.1007/s12028-007-0001-4

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  • DOI: https://doi.org/10.1007/s12028-007-0001-4

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