J Cerebrovasc Endovasc Neurosurg.  2015 Sep;17(3):239-245. 10.7461/jcen.2015.17.3.239.

Reversible Cerebral Vasoconstriction Syndrome and Posterior Reversible Encephalopathy Syndrome Presenting with Deep Intracerebral Hemorrhage in Young Women

• Lee WJ
• Yeon JY
• Jo KI
• Kim JS
• Hong SC

• KMID: 2069250
• DOI: http://doi.org/10.7461/jcen.2015.17.3.239

Abstract

Reversible cerebral vasoconstriction syndrome (RCVS) is a group of syndromes characterized by reversible segmental constriction of cerebral arteries. Posterior reversible encephalopathy syndrome (PRES) is another clinical-radiologic syndrome characterized by reversible, posterior-predominant brain edema. Although the exact causes of these reversible syndromes are poorly understood, these entities may share some common pathophysiologic elements leading to hemorrhagic strokes and rarely, deep intracerebral hemorrhage (ICH). Recent studies have suggested that endothelial dysfunction is a common pathophysiologic factor associated with these syndromes. We report on two young female patients who presented with deep ICH and were later diagnosed as RCVS and PRES. Both patients suffered from vasoconstriction and delayed ischemic stroke. Early detection of distinguishing clinical-radiologic features associated with these reversible syndromes and removing triggers would facilitate successful treatment with no complications.

Keyword

Cerebral vasospasm; Cerebral arteries; Cerebral hemorrhage; Posterior reversible encephalopathy syndrome (PRES)

MeSH Terms

Brain Edema
Cerebral Arteries
Cerebral Hemorrhage*
Constriction
Female
Humans
Posterior Leukoencephalopathy Syndrome*
Stroke
Vasoconstriction*
Vasospasm, Intracranial