Kasuya Chisato, Suzuki Mina, Koda Yukako, Sato Hitomi, Kashima Katsunori, Honda Keisuke, Kazama Yoshiki, Akiyama Katsuhiko, Seki Yasuhiro, Yoneoka Yuichiro
Department of Obstetrics and Gynecology, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Minami-Uonuma, Niigata, Japan.
Department of Neurosurgery, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Minami-Uonuma, Niigata, Japan.
Oxf Med Case Reports. 2018 Nov 21;2018(12):omy101. doi: 10.1093/omcr/omy101. eCollection 2018 Dec.
A 32-year-old pregnant woman in her 39th week of pregnancy presented at the emergency room complaining of sudden-onset dizziness with gaze disturbance and was admitted to our hospital. Her past medical history included hypertension, diabetes mellitus and infarction in the right medulla oblongata 18 months prior to this event. Magnetic resonance (MR) angiography showed multiple irregular stenosis of the intracranial arterial system. Although MR images revealed no fresh ischemic or hemorrhagic lesions, she was diagnosed with reversible cerebral vasoconstriction syndrome (RVCS) associated with pregnancy. Cesarean section immediately resolved the headache-free ischemic RCVS. The postpartum course of the patient was uneventful as well as that of her baby. Follow-up MR angiography showed improvement of intracranial vasoconstriction and follow-up MR imaging showed improvement of a left medial pontine ischemic lesion on diffusion-weighted image. This report describes a rare manifestation of pregnancy-related RCVS.
一名39周妊娠的32岁孕妇因突发头晕伴凝视障碍就诊于急诊室，随后入住我院。她既往有高血压、糖尿病病史，此次发病前18个月曾发生右延髓梗死。磁共振血管造影显示颅内动脉系统多处不规则狭窄。尽管磁共振成像未发现新发缺血性或出血性病变，但她被诊断为与妊娠相关的可逆性脑血管收缩综合征（RVCS）。剖宫产术后，无头痛的缺血性RVCS立即得到缓解。患者产后及婴儿的病程均顺利。随访磁共振血管造影显示颅内血管收缩改善，随访磁共振成像显示扩散加权图像上左侧脑桥内侧缺血性病变有所改善。本报告描述了妊娠相关RVCS的一种罕见表现。
