Reversible cerebral vasoconstriction syndrome

Case contributed by Dr Chris O'Donnell


PH of migraine. 2 weeks of recurrent severe headache now with perisistent lower limb weakness and numbness (left greater than right). No ilicit drug use. Not pregnant.

Patient Data

Age: 35 years
Gender: Female

Initial MRI at time of presentation

Multiple sites of restricted diffusion especially in the right hemisphere (confirmed on ADC) associated with mutiple sites of arterial luminal narrowing especially on the right but also the left (anterior and posterior circulation).


Repeat MRI 3 months later

Complete resolution of vascular narrowing.  Residual gliosis and atrophy at sites of previous infarction.

Case Discussion

This case is typical of reversible vasoconstriction ie a young woman with thunderclap headache and neurological deficit (in this case causing infarction).  No subarachnoid hemorrhage.  Spontaneous resolution of vasoconstriction over time thus not due to established angiitis.  No specific precipiating features such as illicit drug use ie cocaine and metamphetamine.

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Case information

rID: 43356
Published: 6th Mar 2016
Last edited: 21st Aug 2020
Inclusion in quiz mode: Included

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