• Satoshi Kodama, Tatsuo Mano, Akihiro Masuzawa, Yasutaka Hirata, Yuki Nagasako, Kagari Koshi Mano, Masashi Hamada, Yasuo Terao, Toshihiro Hayashi, Minoru Ono, and Shoji Tsuji.
• Department of Neurology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
• J Stroke Cerebrovasc Dis. 2017 May 1; 26 (5): e75-e77.

AbstractReversible cerebral vasoconstriction syndrome (RCVS) is a cerebrovascular syndrome characterized by multi-segmental constrictions of the cerebral arteries that resolves spontaneously within 3 months. Although RCVS is considered to be due to transient dysregulation of vascular tone, the exact pathomechanism remains unclear. We describe the case of a 15-year-old girl with RCVS induced by tacrolimus, who developed generalized seizure during the postoperative course of orthotropic heart transplantation. Magnetic resonance imaging at symptom onset showed a few vasoconstrictions accompanying brain edema and convexity subarachnoid hemorrhage. Although her neurological conditions rapidly improved after discontinuing tacrolimus, a repeat magnetic resonance angiogram demonstrated delayed progression of the multi-segmental vasoconstrictions followed by subsequent resolution. Our case demonstrates that cautious observation of the cerebral arteries using magnetic resonance angiography and careful management of vasoconstrictions with vasodilators are necessary for delayed vasoconstrictions even when the clinical symptoms improve.Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

42 keywords...

hide…