J Korean Soc Radiol.  2013 Nov;69(5):343-346. 10.3348/jksr.2013.69.5.343.

Reversible Cerebral Vasoconstriction Syndrome: A Case Report

• Lee JS
• Park JK
• Kim SH
• Jeong SY

• KMID: 2002851
• DOI: http://doi.org/10.3348/jksr.2013.69.5.343

Abstract

We report a 46-year-old woman patient with reversible cerebral vasoconstriction syndrome (RCVS). She presented with severe headache, multiple cerebral infarction, and multifocal severe stenosis in the intracranial arteries on magnetic resonance angiography (MRA). One month after the episode, a small bowel gastrointestinal stromal tumor (GIST) was incidentally detected during the evaluation of severe anemia and GIST was removed. Follow-up MRA was performed 3 months and 1 year after an initial attack of headache, and multifocal severe intracranial arterial stenotic lesions were completely resolved, she did not experience any episode of RCVS during the 2 years.

MeSH Terms

Anemia
Arteries
Cerebral Infarction
Constriction, Pathologic
Female
Follow-Up Studies
Gastrointestinal Stromal Tumors
Headache
Humans
Magnetic Resonance Angiography
Middle Aged
Stroke
Vasoconstriction*

Figure

• 

  Fig. 1 MR imaging features of RCVS in a 46-year-old woman. A-E. Diffusion-weighted imaging (A), apparent diffusion coefficient map (B), and FLAIR (D, E) show early subacute infarctions in the right PCA and left ACA territories. T2*-gradient echo imaging (C) shows early subacute ICH in the right occipital lobe. FLAIR (E) shows subtle sulcal hyperintensity (arrow) that is suspicious for convexity SAH. F. Time-of-flight MRA shows multifocal segmental severe narrowing with or without adjacent segmental dilatation in bilateral MCA, ACA, PCA, basilar artery, and distal vertebral artery. Note.-ACA = anterior cerebral artery, FLAIR = fluid attenuated inversion recovery, ICH = intracerebral hemorrhage, MRA = magnetic resonance angiography, PCA = posterior cerebral artery, RCVS = reversible cerebral vasoconstriction syndrome, SAH = subarachnoid hemorrhage

• 

  Fig. 2 Follow-up MR imaging 3 months after initial attack of RCVS. A. Multifocal severe stenosis disappears on time-of-flight MRA and intracranial arteries looks as normal. B. FLAIR imaging shows resolution of the lesions with subtle residual high signal intensity in the infarction area and low signal intensity in the ICH area. Note.-FLAIR = fluid attenuated inversion recovery, ICH = intracerebral hemorrhage, MRA = magnetic resonance angiography, RCVS = reversible cerebral vasoconstriction syndrome

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