Tada Masayoshi
Department of Neurology and Neurovascular Medicine, Niigata City General Hospital.
No Shinkei Geka. 2021 Mar;49(2):342-348. doi: 10.11477/mf.1436204396.
Reversible cerebral vasoconstriction syndrome(RCVS)is a clinical and radiological syndrome that is characterized by recurrent severe thunderclap headaches with or without other neurological symptoms and diffuse segmental constriction of cerebral arteries that usually resolves spontaneously within three months. Posterior reversible encephalopathy syndrome(PRES)is also a clinical and radiological syndrome characterized by headache, seizures, altered consciousness, cortical blindness, other focal neurological signs, and a diagnostic imaging picture of brain vasogenic edema. Both syndromes can occur in similar clinical contexts such as hypertension, pre-eclampsia/eclampsia, drug neurotoxicity, uremia, and some autoimmune diseases, and are frequently associated. Although the syndromes are usually fully reversible with early diagnosis and prompt treatment, some cases can develop hemorrhagic or ischemic brain lesions, often resulting in permanent disability. We need to be aware of the typical and atypical imaging manifestations of the syndromes to make an accurate diagnosis.
可逆性脑血管收缩综合征(RCVS)是一种临床和影像学综合征,其特征为反复出现严重的霹雳样头痛,伴有或不伴有其他神经系统症状,以及脑动脉弥漫性节段性收缩,通常在三个月内自发缓解。后部可逆性脑病综合征(PRES)也是一种临床和影像学综合征,其特征为头痛、癫痫发作、意识改变、皮质盲、其他局灶性神经体征,以及脑血管源性水肿的诊断性影像学表现。这两种综合征都可发生于类似的临床背景,如高血压、先兆子痫/子痫、药物神经毒性、尿毒症和一些自身免疫性疾病,且常相关联。尽管这些综合征通常通过早期诊断和及时治疗可完全逆转,但有些病例可发展为出血性或缺血性脑病变,常导致永久性残疾。我们需要了解这些综合征的典型和非典型影像学表现以做出准确诊断。