Rafi Aibani, Morgan Koontz, James S Harman, Amir Kamran, Khawaja Omar
{"title":"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。","authors":"Rafi Aibani, Morgan Koontz, James S Harman, Amir Kamran, Khawaja Omar","doi":"10.55729/2000-9666.1482","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Case report: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":15460,"journal":{"name":"Journal of Community Hospital Internal Medicine Perspectives","volume":"15 3","pages":"68-72"},"PeriodicalIF":0.6000,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12313128/pdf/","citationCount":"0","resultStr":"{\"title\":\"Reversible Cerebral Vasoconstriction Syndrome Induced by Sumatriptan: A Case Report and Review of Literature.\",\"authors\":\"Rafi Aibani, Morgan Koontz, James S Harman, Amir Kamran, Khawaja Omar\",\"doi\":\"10.55729/2000-9666.1482\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Case report: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>\",\"PeriodicalId\":15460,\"journal\":{\"name\":\"Journal of Community Hospital Internal Medicine Perspectives\",\"volume\":\"15 3\",\"pages\":\"68-72\"},\"PeriodicalIF\":0.6000,\"publicationDate\":\"2025-05-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12313128/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Community Hospital Internal Medicine Perspectives\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.55729/2000-9666.1482\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Community Hospital Internal Medicine Perspectives","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.55729/2000-9666.1482","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
Reversible Cerebral Vasoconstriction Syndrome Induced by Sumatriptan: A Case Report and Review of Literature.
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.
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.