一名产后妇女甲状腺毒症后出现的同步性可逆性脑血管收缩综合征
Synchronous reversible cerebral vasoconstriction syndrome following thyrotoxicosis in a postpartum woman.
作者信息
Arakaki Daichi, Terasawa Teruhiko, Iwata Mitsunaga, Uenishi Norimichi
机构信息
Department of Emergency and General Internal Medicine Fujita Health University School of Medicine Toyoake Japan.
Department of Emergency and General Internal Medicine Department of Acute Intensive Care Unit Fujita Health University Hospital Toyoake Japan.
出版信息
Acute Med Surg. 2020 Sep 22;7(1):e570. doi: 10.1002/ams2.570. eCollection 2020 Jan-Dec.
BACKGROUND
Reversible cerebral vasoconstriction syndrome (RCVS) typically manifests with acute-onset, recursive, severe headache that continues for a month; it rarely manifests as seizures. Development of RCVS following thyrotoxicosis has not been previously reported in detail.
CASE PRESENTATION
A 30-year-old postpartum woman with thyrotoxicosis developed a generalized seizure refractory to anticonvulsants. Magnetic resonance angiography demonstrated cerebral artery stenosis in the right anterior cerebral artery and the right middle cerebral artery. These findings were compatible with RCVS. Reversible cerebral vasoconstriction syndrome was treated successfully with i.v. nicardipine and conventional management was undertaken for thyrotoxicosis.
CONCLUSION
This is the first well-documented case of a postpartum woman with synchronous RCVS following thyrotoxicosis. Reversible cerebral vasoconstriction syndrome and thyrotoxicosis can coincidentally occur in postpartum women and manifest with postpartum seizures.
背景
可逆性脑血管收缩综合征（RCVS）通常表现为急性起病、反复出现的严重头痛，持续一个月；很少表现为癫痫发作。此前尚未详细报道过甲状腺毒症后发生RCVS的情况。
病例介绍
一名30岁患有甲状腺毒症的产后妇女发生了对抗惊厥药难治的全身性癫痫发作。磁共振血管造影显示右侧大脑前动脉和右侧大脑中动脉的脑动脉狭窄。这些发现与RCVS相符。静脉注射尼卡地平成功治疗了可逆性脑血管收缩综合征，并对甲状腺毒症进行了常规治疗。
结论
这是第一例有充分记录的产后妇女在甲状腺毒症后同时发生RCVS的病例。可逆性脑血管收缩综合征和甲状腺毒症可在产后妇女中同时出现，并表现为产后癫痫发作。
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