Reversible Cerebral Vasoconstriction Syndrome Induced by Sumatriptan: A Case Report and Review of Literature.

IF 0.6 Q3 MEDICINE, GENERAL & INTERNAL
Rafi Aibani, Morgan Koontz, James S Harman, Amir Kamran, Khawaja Omar
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引用次数: 0

Abstract

Background: Reversible Cerebral Vasoconstriction Syndrome (RCVS) is characterized by multiple transient cerebral vasoconstrictions that typically resolve within three months, often presenting with sudden thunderclap headaches. Although the cause can be identified in 25 %-60 % of cases, RCVS can also occur spontaneously. Common triggers include vasoactive substances and postpartum states, with the latter accounting for 50 %-60 % of cases. This report discusses a case of RCVS following sumatriptan use.

Case report: A 58-year-old woman with controlled hypertension and obstructive sleep apnea presented with recurrent unilateral pulsating headaches, nausea, and photophobia. Initially diagnosed as migraine, she later developed right homonymous hemianopia. Imaging revealed bilateral occipital and parietal strokes with intracranial vasoconstriction. Cerebral angiography confirmed vasospasm, responsive to intra-arterial milrinone. Diagnosed with reversible cerebral vasoconstriction syndrome, she was treated with nimodipine, resulting in complete symptom resolution.

Conclusion: RCVS is a rare syndrome with varied triggers and clinical features, requiring careful evaluation and management. Early diagnosis and vasospasm-targeted therapies, such as nimodipine, are essential for preventing complications. This case underscores the importance of considering RCVS in patients with sudden severe headaches and neurological deficits, particularly those using serotonergic medications.

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舒马曲坦致可逆性脑血管收缩综合征1例报告及文献复习。
背景:可逆性脑血管收缩综合征(RCVS)的特征是多发性短暂性脑血管收缩,通常在3个月内消退,常表现为突然的雷击性头痛。虽然在25% - 60%的病例中可以确定病因,但RCVS也可以自发发生。常见的触发因素包括血管活性物质和产后状态,后者占50% - 60%的病例。本报告讨论了一个使用舒美司坦后发生RCVS的病例。病例报告:一名58岁女性,患有控制高血压和阻塞性睡眠呼吸暂停,表现为反复的单侧搏动性头痛,恶心和畏光。她最初被诊断为偏头痛,后来发展为右眼同义性偏视。影像学显示双侧枕部和顶叶中风伴颅内血管收缩。脑血管造影证实血管痉挛,动脉内注射米力酮有反应。诊断为可逆性脑血管收缩综合征,给予尼莫地平治疗,症状完全缓解。结论:RCVS是一种罕见的综合征,具有多种触发因素和临床特征,需要仔细评估和处理。早期诊断和针对血管痉挛的治疗,如尼莫地平,对于预防并发症至关重要。该病例强调了在突发性严重头痛和神经功能障碍患者中考虑RCVS的重要性,特别是那些使用血清素能药物的患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
自引率
0.00%
发文量
106
审稿时长
17 weeks
期刊介绍: JCHIMP provides: up-to-date information in the field of Internal Medicine to community hospital medical professionals a platform for clinical faculty, residents, and medical students to publish research relevant to community hospital programs. Manuscripts that explore aspects of medicine at community hospitals welcome, including but not limited to: the best practices of community academic programs community hospital-based research opinion and insight from community hospital leadership and faculty the scholarly work of residents and medical students affiliated with community hospitals.
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