• Makoto Takemaru, Shinichi Takeshima, Naoyuki Hara, Takahiro Himeno, Yuji Shiga, Jun Takeshita, Kazuhiro Takamatsu, Eiichi Nomura, Yutaka Shimoe, and Masaru Kuriyama.
• Brain Attack Center, Ota Memorial Hospital, Department of Neurology.
• Rinsho Shinkeigaku. 2018 Jun 27; 58 (6): 377-384.

AbstractThis study reports eleven cases of reversible cerebral vasospasm syndrome (RCVS). Of the 11 patients, two were males and nine were females, with the average age of 47.9 ± 14.1 years. Many of these patients were young. The rates of severe, intractable and pulsative headache, generalized convulsions, and motor hemiparesis were 64%, 27%, and 36%, respectively. As complications of intracerebral lesions in the early stage of disease onset, convexal subarachnoid hemorrhage, lobar intracerebral hemorrhage, and posterior reversible encephalopathy syndrome were observed in 63%, 9%, and 45% of cases, respectively. Cerebral infarction occurred in 45% of cases at around 1-3 weeks after onset. Improvement of cerebral vasoconstriction was recognized in several cases from about the first month of onset. The post-partum period, migraine, transfusion, rapid amelioration for anemia, renal failure, bathing, and cerebrovascular dissection were suspected as disease triggers. Abnormally high blood pressure at onset was confirmed in 55% of cases. It is important to analyze the pathophysiology of RCVS associated with these triggers from the viewpoint of the breakdown of the blood-brain barrier.

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