Decreased Hyperintense Cerebral Arteries on Susceptibility-Weighted Imaging in Reversible Cerebral Vasoconstriction Syndrome

Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by reversible constriction of the intracranial arteries with a thunderclap headache and is associated with a number of clinical settings, including pregnancy and puerperium, exposure to drugs and blood products, and miscellaneous conditions. On magnetic resonance fluidattenuated inversion recovery (FLAIR) images, hyperintense vessels (HVs) have been reported in cases of RCVS, enabling early diagnosis. Susceptibility-weighted imaging (SWI) is a high-resolution, three-dimensional, gradient-echo T2 MR technique that features flow-related arterial enhancement and a high sensitivity to altered concentrations of deoxyhemoglobin. Here, we report a 25-year-old female with puerperium RCVS with decreased hyperintense cerebral arteries on SWI in the absence of HVs on FLAIR images.