Long-Term Outcomes After Reversible Cerebral Vasoconstriction Syndrome

Background and Purpose—

We aimed to further investigate the long-term outcomes after reversible cerebral vasoconstriction syndrome (RCVS).

Methods—

A longitudinal follow-up study was conducted in 173 RCVS patients.

Results—

Of the 172 patients who completed a mean follow-up of 9.2±3.3 years, 10 had a recurrent RCVS that was benign in all. Independent predictors of relapse were having a history of migraine and having exercise as a trigger for thunderclap headache during initial RCVS. After new delivery, the rate of postpartum RCVS was 9%.

Conclusions—

Overall, long-term outcome after RCVS is excellent.

Concomitant reversible cerebral vasoconstriction syndrome and transient global amnesia

BACKGROUND

Reversible cerebral vasoconstriction syndrome (RCVS) is a common cause of thunderclap headache (TCH), mainly recurrent, sometimes associated with seizures and/or neurological deficit. Association with amnesia is exceptional. We report a case series of RCVS concomitant with transient global amnesia (TGA) and propose pathophysiologic hypotheses.

METHODS

We retrospectively reviewed clinical and radiological features of patients diagnosed with confirmed concomitant RCVS and TGA between 2012 and 2018 in two specialized institutions.

RESULTS

Two women aged 67 and 53, and a 64-year-old man had a first thunderclap headache triggered by an acute emotional stress, rapidly followed by TGA. Amnesia resolved within a few hours and RCVS was proven for all, with complete resolution of vasospasms within 3 months. All three patients had excellent outcome.

CONCLUSIONS

RCVS and TGA can occur simultaneously, which suggests common mechanisms such as aberrant responses to physical or emotional stress and cerebral vasoconstriction.