Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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Reversible Cerebral Vasoconstriction Syndrome Presenting as Transient Vessel Wall Enhancement on Contrast-Enhanced Fluid-Attenuated Inversion Recovery Images: A Case Report and Literature Review

조영증강 유체감쇠반전회복기법 영상에서 일과성 혈관 벽 조영증강으로 나타나는 가역성 대뇌 혈관 수축 증후군: 증례 보고 및 문헌 고찰

  • Sun Ah Heo (Department of Radiology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Eun Soo Kim (Department of Radiology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Yul Lee (Department of Radiology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine)
  • 허선아 (한림대학교 의과대학 한림대학교성심병원 영상의학과) ;
  • 김은수 (한림대학교 의과대학 한림대학교성심병원 영상의학과) ;
  • 이열 (한림대학교 의과대학 한림대학교성심병원 영상의학과)
  • Received : 2019.08.01
  • Accepted : 2020.01.14
  • Published : 2020.09.01
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Abstract

Reversible cerebral vasoconstriction syndrome (RCVS) is a clinical and radiological syndrome with primary features that include hyperacute onset of severe headache and segmental vasoconstriction of the cerebral arteries, which resolve within 3 months. Vessel wall enhancement has been reported in some cases of RCVS; however, its pathophysiological and diagnostic implications remain unclear. We review a case of RCVS in a patient with transient vessel wall enhancement on contrast-enhanced fluid-attenuated inversion recovery images, focusing on the pathophysiological and diagnostic implications.

가역성 대뇌 혈관 수축 증후군(reversible cerebral vasoconstriction syndrome)은 벼락두통과 함께 3개월 안에 소실되는 뇌혈관의 다발성 협착을 특징으로 하는 임상적 영상의학적 증후군이다. 해당 환자 중 일부에서 혈관 벽 조영증강이 보고되고 있으나 그 병태생리학적 의미와 진단적 가치는 불분명하다. 이에 혈관 벽 조영증강을 동반한 가역성 대뇌 혈관 수축 증후군의 증례를 보고하고 병태생리학적 의미와 진단적 가치를 고찰하고자 한다.

Keywords

References

  1. Miller TR, Shivashankar R, Mossa-Basha M, Gandhi D. Reversible cerebral vasoconstriction syndrome, part 1: epidemiology, pathogenesis, and clinical course. AJNR Am J Neuroradiol 2015;36:1392-1399 https://doi.org/10.3174/ajnr.A4214
  2. Miller TR, Shivashankar R, Mossa-Basha M, Gandhi D. Reversible cerebral vasoconstriction syndrome, part 2: diagnostic work-up, imaging evaluation, and differential diagnosis. AJNR Am J Neuroradiol 2015;36:1580-1588 https://doi.org/10.3174/ajnr.A4215
  3. Chen CY, Chen SP, Fuh JL, Lirng JF, Chang FC, Wang YF, et al. Vascular wall imaging in reversible cerebral vasoconstriction syndrome - a 3-T contrast-enhanced MRI study. J Headache Pain 2018;19:74
  4. Singhal AB, Topcuoglu MA. Glucocorticoid-associated worsening in reversible cerebral vasoconstriction syndrome. Neurology 2017;88:228-236 https://doi.org/10.1212/WNL.0000000000003510
  5. Mandell DM, Matouk CC, Farb RI, Krings T, Agid R, TerBrugge K, et al. Vessel wall MRI to differentiate between reversible cerebral vasoconstriction syndrome and central nervous system vasculitis: preliminary results. Stroke 2012;43:860-862 https://doi.org/10.1161/STROKEAHA.111.626184
  6. Obusez EC, Hui F, Hajj-Ali RA, Cerejo R, Calabrese LH, Hammad T, et al. High-resolution MRI vessel wall imaging: spatial and temporal patterns of reversible cerebral vasoconstriction syndrome and central nervous system vasculitis. AJNR Am J Neuroradiol 2014;35:1527-1532 https://doi.org/10.3174/ajnr.A3909
  7. Han JS, Mandell DM, Poublanc J, Mardimae A, Slessarev M, Jaigobin C, et al. BOLD-MRI cerebrovascular reactivity findings in cocaine-induced cerebral vasculitis. Nat Clin Pract Neurol 2008;4:628-632 https://doi.org/10.1038/ncpneuro0918
  8. Lee MJ, Cha J, Choi HA, Woo SY, Kim S, Wang SJ, et al. Blood-brain barrier breakdown in reversible cerebral vasoconstriction syndrome: implications for pathophysiology and diagnosis. Ann Neurol 2017;81:454-466 https://doi.org/10.1002/ana.24891
  9. Lee EK, Lee EJ, Kim S, Lee YS. Importance of contrast-enhanced fluid-attenuated inversion recovery magnetic resonance imaging in various intracranial pathologic conditions. Korean J Radiol 2016;17:127-141 https://doi.org/10.3348/kjr.2016.17.1.127
  10. Sanossian N, Saver JL, Alger JR, Kim D, Duckwiler GR, Jahan R, et al. Angiography reveals that fluid-attenuated inversion recovery vascular hyperintensities are due to slow flow, not thrombus. AJNR Am J Neuroradiol 2009;30:564-568 https://doi.org/10.3174/ajnr.A1388