Sheikh Huma U, Mathew Paul G
Brigham and Women's Hospital, Department of Neurology, John R. Graham Headache Center, Harvard Medical School, 1153 Centre Street, Suite 4970, Boston, MA, 02130, USA,
Curr Pain Headache Rep. 2014 May;18(5):414. doi: 10.1007/s11916-014-0414-7.
Reversible cerebral vasoconstriction syndrome (RCVS) is an important cause of headaches that can lead to other neurological complications, including stroke, if not recognized early. Over the past few years, there has been great progress in the recognition of this entity. However, there is still much to be learned about its pathophysiology and optimal treatment strategies. RCVS occurs mostly in middle-aged adults, and there is a female preponderance with an increased incidence during the postpartum period. A consistent, predominating feature is a sudden-onset, severe headache that is frequently recurrent, usually over the span of a week. Less common presentations include seizures or focal neurological symptoms. Important causative factors include vasoactive medications, as well as illicit drugs like marijuana and cocaine. The current underlying pathophysiology is thought to be a disturbance in cerebrovascular tone leading to vasoconstriction. The diagnosis is based on history, physical examination, and cerebrovascular imaging findings that demonstrate multifocal, segmental areas of vasoconstriction in large- and medium-sized arteries. An important criterion for making the diagnosis is the eventual reversibility of symptoms and imaging findings.
可逆性脑血管收缩综合征（RCVS）是头痛的一个重要原因，如果不及早识别，可能会导致包括中风在内的其他神经系统并发症。在过去几年中，对这一病症的认识有了很大进展。然而，关于其病理生理学和最佳治疗策略仍有许多有待了解之处。RCVS大多发生在中年成年人中，女性占优势，产后发病率增加。一个一致的主要特征是突然发作的严重头痛，通常在一周内频繁复发。较少见的表现包括癫痫发作或局灶性神经症状。重要的致病因素包括血管活性药物以及大麻和可卡因等非法药物。目前认为潜在的病理生理学是脑血管张力紊乱导致血管收缩。诊断基于病史、体格检查以及脑血管成像结果，这些结果显示大中型动脉存在多灶性、节段性血管收缩区域。做出诊断的一个重要标准是症状和成像结果最终的可逆性。
