Call-Fleming syndrome, also called Call syndrome, is a subset of reversible cerebral vasoconstriction syndrome. It is characterised by a history of thunderclap headache with subsequent beaded appearance of the circle of Willis on angiography (as seen in RCVS), but with no identifiable cause.
History and etymology
It was first described by Call and Fleming et al, in 1988 2 where they described 19 patients with "reversible cerebral arterial segmental vasoconstriction", who presented with thunderclap headaches with or without focal neurology, without evidence of subarachnoid haemorrhage (SAH). A number of predisposing factors have since been found to contribute to what is now described as RCVS. However, idiopathic cases of RCVS still exist and are now named Call-Fleming.
- 1. Calabrese LH, Dodick DW, Schwedt TJ et-al. Narrative review: reversible cerebral vasoconstriction syndromes. Ann. Intern. Med. 2007;146 (1): 34-44. Ann. Intern. Med. (full text) - Pubmed citation
- 2. Call GK, Fleming MC, Sealfon S et-al. Reversible cerebral segmental vasoconstriction. Stroke. 1988;19 (9): 1159-70. Stroke (abstract) - Pubmed citation
- 3. Moustafa RR, Allen CM, Baron JC. Call-Fleming syndrome associated with subarachnoid haemorrhage: three new cases. BMJ Case Rep. 2009;2009 doi:10.1136/bcr.09.2008.0989 - Free text at pubmed - Pubmed citation
- 4. Noskin O, Jafarimojarrad E, Libman RB et-al. Diffuse cerebral vasoconstriction (Call-Fleming syndrome) and stroke associated with antidepressants. Neurology. 2006;67 (1): 159-60. doi:10.1212/01.wnl.0000223648.76430.27 - Pubmed citation