출산 후 발생한 가역적 뇌혈관 수축 증후군 1예

A Case of Postpartum Reversible Cerebral Vasoconstriction Syndrome

본 증례는 건강했던 젊은 여성이 출산 이후 벼락두통으로 내원하였고 뇌자기공명혈관 조영술을 이용하여 RCVS로 진단한 증례로 문헌고찰과 함께 이를 보고하는 바이다.

Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by development of a severe thunderclap headache with or without other acute neurological symptoms, and by multifocal or diffuse segmental vasoconstriction of the cerebral arteries that resolves spontaneously within 3 months. Several precipitating factors have been identified; these include the use of adrenergic or serotonergic drugs and postpartum status. Diagnosis is aided by the dynamic nature of the clinicoradiological features, including a ‘beads-on-a-string’ appearance of the cerebral arteries on angiography, and complete (or near-complete) resolution of the condition evident on repeat angiography performed 3 months after initial onset. Calcium channel blockers such as nimodipine seem to relieve the severe headache within 48 h. Here, we present the case of a female who developed RCVS postpartum.