  |
|
 |
|
Case Report
| ||||||
| Reversible cerebral vasoconstriction syndrome in HELLP syndrome | ||||||
| Shinji Katsuragi1, Masato Osaki2, Rieko Suzuki3, Tomoaki Ikeda4, Kazunori Toyoda5, Jun Yoshimatsu6 | ||||||
|
1MD, Chirman, Obstetric Cardiology, Sakakibara Heart Institute, Fuchu, Tokyo, Japan.
2MD, Resident, Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan. 3MD, Staff, Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan. 4MD, Professor, Obstetrics and Gynecology, Mie University, Tsu, Mie, Japan. 5MD, Chirman Cerebrovascular Medicine, National Cereral and Cardiovascular Center, Suita, Osaka, Japan. 6MD, Chairman, Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan. | ||||||
| ||||||
|
[HTML Full Text]
[PDF Full Text]
[Print This Article]
[Similar article in Pumed] [Similar article in Google Scholar] 
|
| How to cite this article |
| Katsuragi S, Osaki M, Suzuki R, Ikeda T, Toyoda K, Yoshimatsu J. Reversible cerebral vasoconstriction syndrome in HELLP syndrome. International Journal of Case Reports and Images 2013;4(12):735–738. |
|
Abstract
|
|
Introduction:
Reversible cerebral vaso-constriction syndrome (RCVS) is characterized by severe and hyperacute headaches with or without additional focal neurological deficits, and evidence of vasoconstriction of cerebral arteries which resolves spontaneously within 1–3 months. However, the precise mechanism of RCVS is not fully understood.
Case Report: We report a 33-year-old postpartum woman with RCVS with HELLP syndrome and eclampsia. Magnetic resonance angiography (MRA) of head revealed transient segmental stenosis and dilatation. Especially, most part of the middle cerebral artery (MCA) was irregularly thinner at the acute phase than have ever previously reported. Transcranial color flow imaging (TCCFI) showed the highest peak systolic velocity of middle cerebral artery that has ever reported in RCVS cases (330 cm/s). Histologically, the large areas that showed cytotoxic edema on magnetic resonance imaging at acute phase, which indicated possible infarction at the chronic stage, have eventually become normal in chronic stage. Conclusion: This RCVS case occurred to a postpartum woman in HELLP syndrome after eclampsia. The peak velocity of MCA measured by TCCFI was the highest so far ever reported in RCVS cases, and vasoconstriction on MRA was severe. However, the severe vasoconstriction did not last long enough to cause infarction in brain tissue in this case. TCCFI also shows the steep decline of the peak velocity of MCA after acute phase and through this case we reconfirm the usefulness of TCCFI as this bed-side test reflects quite well the changes of vasoconstriction in severe RCVS case. | |
|
Keywords:
RCVS (Reversible Cerebral Vasoconstriction Syndrome), Pregnancy, TCCFI (Transcranial color flow imaging), peak systolic velocity
| |
|
[HTML Full Text]
[PDF Full Text]
|
|
Author Contributions
Shinji Katsuragi – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Masato Osaki – Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Rieko Suzuki – Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Tomoaki Ikeda – Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Kazunori Toyoda – Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Jun Yoshimatsu – Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published |
|
Guarantor of submission
The corresponding author is the guarantor of submission. |
|
Source of support
None |
|
Conflict of interest
Authors declare no conflict of interest. |
|
Copyright
© Shinji Katsuragi et al. 2013; This article is distributed the terms of Creative Commons attribution 3.0 License which permits unrestricted use, distribution and reproduction in any means provided the original authors and original publisher are properly credited. (Please see Copyright Policy for more information.) |
|
|