Mijalski Christina, Dakay Katarina, Miller-Patterson Cameron, Saad Ali, Silver Brian, Khan Muhib
Department of Neurology, Rhode Island Hospital/Warren Alpert Medical School of Brown University, Providence, RI, USA.
Neurohospitalist. 2016 Jul;6(3):111-3. doi: 10.1177/1941874415613834. Epub 2015 Oct 30.
We describe 2 cases of reversible cerebral vasoconstriction syndrome (RCVS) with refractory headache aborted by intravenous magnesium. Case 1 is a 53-year-old woman with subarachnoid hemorrhage due to RCVS presented with refractory headache and persistent vasospasm, despite aggressive treatment with calcium channel blockers (CCBs) and systemic corticosteroids. Subsequently, she experienced dramatic relief of symptoms with intravenous magnesium therapy. She continued oral maintenance therapy and remained symptom free. Case 2 is a 71-year-old female with bilateral temporo-occipital infarcts due to RCVS, presented with refractory headache and persistent vasospasm on transcranial Doppler (TCD), despite aggressive treatment with CCBs. She experienced dramatic relief of symptoms with intravenous magnesium and resolution of vasospasm on TCD. Magnesium may be beneficial for the treatment of refractory headaches in patients with RCVS. Future studies are needed to determine whether it should be considered as a first-line agent.
我们描述了2例可逆性脑血管收缩综合征（RCVS）伴难治性头痛的病例，静脉注射镁剂后头痛缓解。病例1是一名53岁女性，因RCVS导致蛛网膜下腔出血，尽管使用钙通道阻滞剂（CCB）和全身糖皮质激素进行了积极治疗，但仍出现难治性头痛和持续性血管痉挛。随后，静脉注射镁剂治疗使她的症状得到显著缓解。她继续接受口服维持治疗，症状未再出现。病例2是一名71岁女性，因RCVS导致双侧颞枕叶梗死，尽管使用CCB进行了积极治疗，但经颅多普勒（TCD）检查仍显示难治性头痛和持续性血管痉挛。静脉注射镁剂后她的症状得到显著缓解，TCD显示血管痉挛消失。镁剂可能有助于治疗RCVS患者的难治性头痛。未来需要进行研究以确定是否应将其视为一线药物。
