Reversible Cerebral Vasoconstriction Syndromes (RCVS)

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Lesion patterns in PACNS 3. Single, hyperintense, mass lesion (one patient, normal angiogram, positive pathology) Molloy, Calabrese & Singhal; Arth Rheum 2008 Note: In the MGH series, PACNS was never associated with normal MRI scans. ICH was rare. It is likely that literature reports of PACNS are confounded by <strong>RCVS</strong>.
Distinguishing <strong>RCVS</strong> from PACNS Clinical differences can be ‘diagnostic’ symptom onset acute in RCV, insidious in vasculitis Clinical distinction can be difficult especially in the acute stages (i.e., before the tempo of the disease is established, and without serial vascular imaging). Neuroimaging (lesion topography) may be helpful, but should be used in conjunction with the clinical features and lab. results to discriminate between these conditions.
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Reversible Cerebral Vasoconstrictio
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Patients (mostly women): rTCH ± st
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Key Elements for Diagnosis 1. Sever
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Characteristic Clinical Features CC
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Laboratory and Imaging Features Cha
Page 12 and 13:
Characteristic Follow-up Imaging CC
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RCVS: Brain Imaging
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Brain Hemorrhage in RCVS Hemorrhage
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• Migraine Differential Diagnosis
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Diagnostic Approach 1. Clinical Rec
Page 22 and 23: Characteristic Treatment and Outcom
Page 24 and 25: CTA before IA treatment (PPD 20) Si
Page 26 and 27: Final MRI 6 Days After Admission Si
Page 28 and 29: RCVS • Group of conditions charac
Page 31 and 32: Stroke attributed to ‘vasospasm
Page 36 and 37: Hemorrhages in 1 st week, Infarcts
Page 38 and 39: Pathophysiology
Page 40 and 41: A B C (A) Headframe used for bedsid
Page 42 and 43: Perivascular nerves smooth muscle c
Page 44 and 45: Endothelium • Modulates vascular
Page 46 and 47: Spectrum - disorders of cerebrovasc
Page 48 and 49: RCVS and Drugs/Meds Ergot derivativ
Page 50 and 51: Serotonin - central role in RCVS? S
Page 52 and 53: Serotonergic meds common…but RCVS
Page 54 and 55: RCVS and Migraine Is RCVS simply a
Page 56 and 57: Neurology 2006: 67:2164 • Prospec
Page 58 and 59: RCVS-SAH (n=35) vs. aSAH (n=515)
Page 60 and 61: RCVS vs. PACNS
Page 63 and 64: Angio positive in 70 cases; biopsy
Page 65 and 66: RCVS vs PACNS: MGH cases, 1993-2009
Page 67 and 68: RCVS vs PACNS: MGH cases, 1993-2009
Page 69 and 70: Brain lesion topography in RCVS 3.
Page 71: Lesion patterns in PACNS 2. Diffuse
Page 75 and 76: Advanced MRI for Cerebral Arteriopa
Page 77 and 78: To study the phenomena of disease w
Page 79 and 80: Illustrative Case 46 year male: acu
Page 81 and 82: Illustrative Case MR angio - severe
Page 84 and 85: PACNS - Typical Angiographic featur
Page 86: Treatment vs Poor Outcome All Patie
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Reversible Cerebral Vasoconstriction Syndromes (RCVS)

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