Anesthesiology, Critical Care and Pain Medicine Division, Department of Medicine and Surgery, University of Parma, Parma, Italy.
Stroke Unit (U.S.), University of Parma, Parma, Italy.
Acta Biomed. 2021 May 4;92(S1):e2021119. doi: 10.23750/abm.v92iS1.10960.
Reversible Cerebral Vasoconstriction Syndrome (RCVS) and Posterior Reversible Encephalopathy Syndrome (PRES) are two rare neurological conditions, clinically characterized by headache. In our case a diagnosis of PDPH was made though imaging showed signs of RCVS-PRES. We present a case of RCVS-PRES in a postpartum woman who presented headache as first symptom and only later experienced seizures. Dural puncture worked as a confounding factor in the clinical postpartum evaluation. We want to focus the attention on changes of clinical characteristics of headache as an important factor to be analysed, in order to have a prompt diagnosis. We therefore propose a diagnostic algorithm. Moreover, we evaluate possible triggers of RCVS and PRES; in our case dural puncture is probably not the trigger, in fact there were no liquoral hypotension signs on imaging.
可逆性脑血管收缩综合征（RCVS）和后部可逆性脑病综合征（PRES）是两种罕见的神经系统疾病，临床上以头痛为特征。在我们的病例中，虽然影像学显示 RCVS-PRES 的迹象，但诊断为 PDPH。我们报告了一例产后妇女出现 RCVS-PRES 的病例，该患者以头痛为首发症状，随后才出现癫痫发作。腰穿在产后临床评估中是一个混杂因素。我们想关注头痛的临床特征变化，作为需要分析的重要因素，以便进行及时诊断。因此，我们提出了一个诊断算法。此外，我们还评估了 RCVS 和 PRES 的可能诱因；在我们的病例中，腰穿可能不是诱因，事实上影像学上没有脑脊液压力降低的迹象。
