Lee Won Jae, Yeon Je Young, Jo Kyung-Il, Kim Jong-Soo, Hong Seung-Chyul
Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
J Cerebrovasc Endovasc Neurosurg. 2015 Sep;17(3):239-45. doi: 10.7461/jcen.2015.17.3.239. Epub 2015 Sep 30.
Reversible cerebral vasoconstriction syndrome (RCVS) is a group of syndromes characterized by reversible segmental constriction of cerebral arteries. Posterior reversible encephalopathy syndrome (PRES) is another clinical-radiologic syndrome characterized by reversible, posterior-predominant brain edema. Although the exact causes of these reversible syndromes are poorly understood, these entities may share some common pathophysiologic elements leading to hemorrhagic strokes and rarely, deep intracerebral hemorrhage (ICH). Recent studies have suggested that endothelial dysfunction is a common pathophysiologic factor associated with these syndromes. We report on two young female patients who presented with deep ICH and were later diagnosed as RCVS and PRES. Both patients suffered from vasoconstriction and delayed ischemic stroke. Early detection of distinguishing clinical-radiologic features associated with these reversible syndromes and removing triggers would facilitate successful treatment with no complications.
可逆性脑血管收缩综合征(RCVS)是一组以脑动脉节段性可逆性收缩为特征的综合征。后部可逆性脑病综合征(PRES)是另一种临床-影像学综合征,其特征为可逆性、以枕叶为主的脑水肿。尽管这些可逆性综合征的确切病因尚不清楚,但这些疾病可能具有一些共同的病理生理因素,可导致出血性卒中,很少会导致深部脑出血(ICH)。最近的研究表明,内皮功能障碍是与这些综合征相关的常见病理生理因素。我们报告了两名年轻女性患者,她们均出现深部脑出血,后来被诊断为RCVS和PRES。两名患者均患有血管收缩和迟发性缺血性卒中。早期发现与这些可逆性综合征相关的独特临床-影像学特征并消除诱因,将有助于成功治疗且无并发症。