Reversible cerebral vasoconstriction syndrome as a cause of simultaneously ischemic and hemorrhagic stroke

dc.contributor.authorCorreia, Carlos Eduardo Rocha
dc.contributor.authorGodeiro, Clécio de Oliveira
dc.contributor.authorLoureiro, C.
dc.contributor.authorLoureiro, A.
dc.contributor.authorLinard, V.
dc.contributor.authorJosé, J.
dc.contributor.authorLaurentino, M.
dc.contributor.authorSantiago, P.
dc.contributor.authorDourado, M.E.
dc.contributor.authorMelo, C.
dc.contributor.authorMarinho, M.
dc.date.accessioned2023-05-26T16:30:31Z
dc.date.available2023-05-26T16:30:31Z
dc.date.issued2015
dc.description.resumoIntroduction: Reversible cerebral vasoconstriction syndrome(RCVS) is characterized by multifocal segmental vasoconstriction of cerebral arteries, which resolve spontaneously within 3 months, typically heralded by a sudden, severe headache with or without neurologic deficit. The main complications are intracranial hemorrhage, ischemic disturbance of the cerebral circulation, hypertensive encephalopathy (PRES) or epileptic seizures. Case: Female, 47 years old, hypertensive and no history of previous migraine, suddenly developed headache associated with paresis of the right upper limb. After a few hours of the onset of symptoms, a CT scan was performed and showed intraparenchymal hemorrhage in left temporal and parietal lobes. The patient evolved with partial and progressive improvement of the symptoms. A week later, a CT scan revealed ischemic area at the right parietal lobe. Magnetic Resonance Angiography was performed, which found narrowing of the right posterior and middle cerebral artery. The patient was treated with prednisone and nimodipine for 3 months. A 90 days later MRA revealed no vascular irregularity anymore. Discussion: Stroke, either hemorrhagic or ischemic is a relatively frequent presentation in RCVS, but simultaneously manifestations of intracerebral hemorrhage, and cerebral infarction was not described. More than half the cases (60%) are secondary to exposure to vasoactive substances or occur in the postpartum period. Cortical subarachnoid hemorrhage (22%), intracerebral hemorrhage (6%), seizures (3%), and reversible posterior leukoencephalopathy (9%) are early complication. Ischemic events, including TIAs (16%) and cerebral infarction (4%), occur later than hemorrhagic strokes. Several case series have reported success with calcium channel blockers or short term glucocorticoids medications.pt_BR
dc.identifier.citationCORREIA, Carlos Eduardo Rocha; et al. Reversible cerebral vasoconstriction syndrome as a cause of simultaneously ischemic and hemorrhagic stroke. Journal Of The Neurological Sciences, [S.L.], v. 357, p. 389, out. 2015. Elsevier BV. http://dx.doi.org/10.1016/j.jns.2015.08.1383. Acesso em: 26 maio 2023.pt_BR
dc.identifier.doi10.1016/j.jns.2015.08.1383
dc.identifier.urihttps://repositorio.ufrn.br/handle/123456789/52534
dc.languagept_BRpt_BR
dc.publisherJournal of the Neurological Sciencespt_BR
dc.subjecthemorrhagept_BR
dc.subjectmagnetic resonance angiographypt_BR
dc.subjecthypertensivept_BR
dc.titleReversible cerebral vasoconstriction syndrome as a cause of simultaneously ischemic and hemorrhagic strokept_BR
dc.typearticlept_BR

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