Yoon Changhyo, Jung Seunguk
Department of Neurology, Gyeongsang National University School of Medicine, Gyeongsang National University Changwon Hospital, Changwon, Korea.
Ann Indian Acad Neurol. 2018 Jul-Sep;21(3):220-222. doi: 10.4103/aian.AIAN_440_17.
Thunderclap headaches, stroke, seizures, and cortical subarachnoid hemorrhage can all reveal reversible cerebral vasoconstriction syndrome (RCVS). Most parenchymal brain lesions occur simultaneously and sequentially with cerebral vasoconstriction in RCVS patients. Therefore, it is not easy to suspect RCVS in patients with only parenchymal brain lesions without vasoconstriction even if they present with a typical thunderclap headache. Furthermore, RCVS should be differentiated from central nervous system vasculitis. However, it is especially difficult to distinguish RCVS from the cerebral involvement of multisystem vasculitis when there is a positive result in the serologic test for autoantibodies. We report a case of RCVS with hidden breast cancer in which ischemic stroke and cortical subarachnoid hemorrhage were observed earlier than vasoconstriction, and there were positive autoantibodies.
霹雳样头痛、中风、癫痫发作和皮质下蛛网膜下腔出血都可能提示可逆性脑血管收缩综合征（RCVS）。在RCVS患者中，大多数脑实质病变与脑血管收缩同时或相继发生。因此，对于仅有脑实质病变而无血管收缩的患者，即使出现典型的霹雳样头痛，也不容易怀疑RCVS。此外，RCVS应与中枢神经系统血管炎相鉴别。然而，当自身抗体血清学检测呈阳性时，尤其难以将RCVS与多系统血管炎的脑部受累区分开来。我们报告一例隐匿性乳腺癌合并RCVS的病例，其中缺血性中风和皮质下蛛网膜下腔出血比血管收缩更早出现，且存在自身抗体阳性。
