可逆性脑血管收缩综合征：多次动脉内注射尼莫地平和血管成形术治疗
Reversible cerebral vasoconstriction syndrome: treatment with multiple sessions of intra-arterial nimodipine and angioplasty.
作者信息
Ioannidis I, Nasis N, Agianniotaki A, Katsouda E, Andreou A
机构信息
Department of Neurosurgery and Interventional Neuroradiology, HYGEIA Hospital, Athens, Greece.
出版信息
Interv Neuroradiol. 2012 Sep;18(3):297-302. doi: 10.1177/159101991201800308. Epub 2012 Sep 10.
Abstract
Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by acute severe headache with or without additional neurological symptoms and reversible cerebral vasoconstriction. Unruptured aneurysms have been reported in some cases with RCVS. We describe a severe case of a 50-year-old woman with RCVS presenting as cortical subarachnoid hemorrhage. Cerebral angiogram demonstrated the typical angiographic findings of RCVS and two very small unruptured aneurysms of the left internal carotid artery. The patient was treated with calcium channel blockers and the two aneurysms were successfully treated endovascularly. On day 16 the patient developed new focal neurological symptoms (severe paraparesis) and was successfully treated with intraarterial nimodipine and angioplasty in multiple sessions.
摘要
可逆性脑血管收缩综合征（RCVS）的特征是伴有或不伴有其他神经系统症状的急性重度头痛以及可逆性脑血管收缩。在一些RCVS病例中曾报告有未破裂动脉瘤。我们描述了一例50岁女性的严重RCVS病例，其表现为皮质下蛛网膜下腔出血。脑血管造影显示出RCVS典型的血管造影表现以及左侧颈内动脉的两个非常小的未破裂动脉瘤。该患者接受了钙通道阻滞剂治疗，两个动脉瘤成功通过血管内治疗。在第16天，患者出现了新的局灶性神经系统症状（严重双侧下肢轻瘫），并通过多次动脉内给予尼莫地平和血管成形术成功治疗。
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