Although described as a separate condition, Call-Fleming or Call syndrome is a subset of reversible cerebral vasoconstriction syndrome. It is characterized by a history of thunderclap headache with subsequent beaded appearance of the Circle of Willis on angiographic imaging (as seen in RCVS), but with no identifiable cause.
History and etymology
It was first described by Call, 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.
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