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Case No. 250
2011-08-01~2011-08-31
출제자 : 황승배
Hit : 556
| Period | 2011-08-01~2011-08-31 |
|---|---|
| Diagnosis | Reversible cerebral vasoconstriction syndrome |
| Clinical information | 7세 여자 C/C : 머리가 터질듯한 심한 두통 Brain CT & Brain MRI 상 특이 소견은 없었음 마지막 3개의 이미지는 2주뒤 추적검사 진단은? |
| Discussion | Reversible cerebral vasoconstriction syndrome -Reversible, multifocal cerebral artery vasoconstriction -Severe headaches +/- focal neurological deficits Pathology -Thought to represent transient disturbance in control of cerebral vascular tone ⊇ vasoconstriction ⊇ ischemia, stroke, death -Spontaneous (1/3 cases) -Precipitaed by post-partum state or exposure to vasoactive substance Imaging -Acute/recurrent headaches + vasculitic pattern (DSA) -DSA = curcial for diagnosis ( 100% sensitive) -Involves larges, medium-sized arteries -Diffuse, multifocal, segmental narrowing -Sometimes ¨string of beads 〃 or ¨sausage strings 〃 -NECT often negative -Small cortical SAHs (20%) +/- parenchymal hemorrhage -CTA/MRA: May be normal if subtle changes (10%) -Diffuse segmental arterial constriction in 90 % |
| Correct answer |
Correct Answer
Semi-Correct Answer |