Rizzati Frida, Marie Guillaume, Chanez Vivianne, Ferry Thomas, Natterer Julia, Longchamp David, Saliou Guillaume, Perez Maria-Helena
Paediatric Intensive Care Unit, Woman, Mother and Child Department, Lausanne University Hospital and Lausanne University, Lausanne, Switzerland.
Department of Radiology, Cantonal Hospital Lucerne, Lucerne, Switzerland.
Front Pediatr. 2023 Mar 3;11:1042509. doi: 10.3389/fped.2023.1042509. eCollection 2023.
Reversible cerebral vasoconstriction syndrome (RCVS) is a vascular disease characterized by diffuse transient vasoconstriction and vasodilatation of the cerebral arteries. It is commonly associated with recurrent severe acute headaches with or without focal neurological deficits due to hemorrhages, infarcts, and even posterior reversible encephalopathy syndrome. The optimal management of acute neurologic deficits caused by RCVS is still uncertain. Calcium channel blockers (CCBs) such as nimodipine or verapamil have been reported to be effective in adult series. Intra-arterial injection of nimodipine, verapamil, and milrinone has recently been demonstrated to be safe and effective for treating severe segmental vasoconstriction in adults. CCBs are the most used treatment in the available pediatric literature. Intra-arterial vasodilators have been reported in some rare pediatric reports with more severe diseases, but their utility is still under investigation. We report a case of a 12-year-old girl who underwent a severe course of RCVS complicated by multiple cerebral infarcts, treated by several sessions of intra-arterial vasodilators infusion.
可逆性脑血管收缩综合征（RCVS）是一种血管疾病，其特征为脑动脉弥漫性短暂血管收缩和扩张。它通常与反复出现的严重急性头痛相关，伴或不伴有因出血、梗死甚至后部可逆性脑病综合征导致的局灶性神经功能缺损。RCVS所致急性神经功能缺损的最佳治疗方法仍不确定。据报道，钙通道阻滞剂（CCB）如尼莫地平和维拉帕米在成人病例系列中有效。最近已证明，动脉内注射尼莫地平、维拉帕米和米力农对治疗成人严重节段性血管收缩是安全有效的。CCB是现有儿科文献中最常用的治疗方法。在一些罕见的儿科重症病例报告中曾提及动脉内血管扩张剂，但对其效用仍在研究中。我们报告一例12岁女孩，其经历了严重的RCVS病程并并发多处脑梗死，通过多次动脉内血管扩张剂输注进行治疗。
