Department of Ophthalmology, Saitama Medical Center, Dokkyo Medical University, 2-1-50 Minamikoshigaya, Koshigaya, Saitama, 343-8555, Japan.
Lively Eye Clinic, 3-1-4 Asahicho, Soka, Saitama, 340-0053, Japan.
J Med Case Rep. 2021 Mar 28;15(1):175. doi: 10.1186/s13256-021-02746-0.
Reversible cerebral vasoconstriction syndrome is characterized by severe headache with reversible segmental constriction of the cerebral arteries. We present details on a patient with reversible cerebral vasoconstriction syndrome who initially visited an ophthalmologist because of visual symptoms.
A 34-year-old Japanese woman complained of sustained headache and insomnia starting 2 days after her first childbirth. In addition to the severe headache, a visual field defect was also observed 10 days later. Best corrected visual acuity at the initial visit was 20/20 and 20/25 for the right and left eye, respectively. Exudative retinal detachment was noted surrounding both optic heads. Visual field testing revealed left homonymous hemianopsia, while magnetic resonance imaging demonstrated the presence of edema and infarction of the bilateral basal nuclei and right occipital lobe. The homonymous hemianopsia and exudative retinal detachment recovered immediately after treatment with a free-radical scavenger and anticoagulant. There has been no recurrence of symptoms during the 4 years of follow-up.
We report a case of reversible cerebral vasoconstriction syndrome with ophthalmological symptoms that were reversible, including serous retinal detachment and homonymous hemianopsia.
可逆性脑血管收缩综合征的特征是严重头痛伴脑动脉节段性可逆收缩。我们报告了一例以视觉症状初诊于眼科的可逆性脑血管收缩综合征患者的详细情况。
一名 34 岁日本女性，首次分娩后 2 天开始出现持续性头痛和失眠。除了严重头痛外，10 天后还观察到视野缺损。初次就诊时最佳矫正视力右眼为 20/20，左眼为 20/25。双侧视盘周围可见渗出性视网膜脱离。视野检查显示左侧同向性偏盲，磁共振成像显示双侧基底核和右侧枕叶存在水肿和梗死。给予自由基清除剂和抗凝治疗后，同向性偏盲和渗出性视网膜脱离立即恢复。在 4 年的随访期间，症状无复发。
我们报告了一例以眼科症状为表现的可逆性脑血管收缩综合征，包括浆液性视网膜脱离和同向性偏盲，这些症状是可逆的。
