Department of Obstetrics, Gynecology, and Women's Health, University of Missouri School of Medicine, Columbia, Missouri.
Obstet Gynecol. 2014 Feb;123(2 Pt 2 Suppl 2):477-479. doi: 10.1097/AOG.0b013e3182a7f20d.
Reversible cerebral vasoconstriction syndrome is characterized by thunderclap headache and reversible cerebral vasoconstriction, with or without other neurologic signs and symptoms.
A 33-year-old woman presented 13 days postpartum with a 4-day history of multiple thunderclap headaches while in the recumbent position, prompting her to attempt to sleep while standing or sitting. Cerebral angiogram demonstrated segmental cerebral artery vasoconstriction. Spinal fluid sampling excluded vasculitis, thereby confirming the diagnosis of reversible cerebral vasoconstriction syndrome. Treatment with a calcium channel antagonist rapidly attenuated her symptoms, and cerebral angiogram was normal at 3 months.
Thunderclap headache during the postpartum period precipitated by valsalva or recumbent positioning may indicate reversible cerebral vasoconstriction syndrome, which, if untreated, places a patient at risk for serious neurologic injury.
可逆性脑血管收缩综合征的特征是霹雳性头痛和可逆性脑血管收缩，伴有或不伴有其他神经体征和症状。
一位 33 岁女性，产后 13 天，呈霹雳性头痛，持续 4 天，仰卧位时头痛加重，尝试站立或坐立时入睡。脑血管造影显示节段性脑血管收缩。腰椎穿刺排除血管炎，从而确诊为可逆性脑血管收缩综合征。钙通道拮抗剂治疗迅速缓解了她的症状，3 个月时脑血管造影正常。
瓦尔萨尔瓦动作或仰卧位诱发的产后霹雳性头痛可能提示可逆性脑血管收缩综合征，如果不治疗，患者可能会出现严重的神经损伤。
