Idiopathic Reversible Cerebral Vasoconstriction Syndrome Complicated by Sub-Arachnoid Bleed

Soorya Hegde1, Janak Nayak, Khadija Rehman Prabhat Sood and Michela Simoni

Department of General Internal Medicine, County Hospital, United Kingdom Department of Acute Internal Medicine, County Hospital, United Kingdom Department of Respiratory Medicine, County Hospital, United Kingdom Department of Neurology, County Hospital, United Kingdom

^*Correspondance to: Soorya Hegde 

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Abstract:

This report describes a case of Idiopathic reversible cerebral vasoconstriction syndrome with a biphasic clinical course, complicated by / presenting as sub-arachnoid haemorrhage (RCVSSAH). In this report, we aim to describe the case of a previously healthy 52-year-old woman who presented with severe occipital headache of sudden-onset, where neuroimaging initially revealed a sub-arachnoid bleed and multi-focal, segmental vasoconstriction of cerebral arteries, raising the concern for reversible cerebral vasoconstriction syndrome. Over the course of the next 4 weeks of inpatient stay, the patient developed focal neurological signs and subsequent imagine revealed worsening of the infarct and vasoconstriction. RCVS was diagnosed after ruling out other causes of cerebral vasoconstriction like infections, vasculitis and aneurysmal sub-arachnoid haemorrhage (aSAH). Follow-up with subsequent imaging demonstrated the resolution of changes which were previously demonstrated along with sequelae of RCVS. The patient also reported significant clinical improvement, with only mild persisting weakness of her legs.

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Cite the Article:

Hegde S, Nayak J, Rehman K, Sood P, Simoni M. Idiopathic Reversible Cerebral Vasoconstriction Syndrome Complicated by Sub-Arachnoid Bleed. Ann Clin Case Rep. 2024; 9: 2689..