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Case No. 287
2012-12-01~2012-12-31
출제자 : 설유리
Hit : 475
| Period | 2012-12-01~2012-12-31 |
|---|---|
| Diagnosis | Reversible cerebral vasoconstriction syndrome (RCVS) |
| Clinical information | F/29 C.C: Lt. upper and lower limb weakness onset after emergency c-sec. Preeclampsia patient, severe headache, nausea |
| Discussion | 정의 Severe headaches with or without seizures or neurologic deficits and constriction of cerebral arteries which resolves spontaneously within 1-3 months Up to 60% are “secondary” Headache (secondary) - “thunderclap variety”, peaks within one minute and very intense Proposed mechanism transient disturbance of cerebral arterial vascular tone in segmental and multifocal fashion Leads to various areas of constriction and/or dilatation Either idiopathic (primary) or secondary (25-60%) Complications Localized cortical SAH (20-25%) Ischemic or hemorrhagic stroke (5-10%) PRES Permanent sequelae of a usually benign entity MRI Usually normal May show evidence of infarctions, especially in “watershed” zones May look like PRES Parenchymal hemorrhages or cortical SAH Angiography Alternating areas of constriction and dilatation – string-of-beads Focal/diffuse vasoconstriction, focal vasodilation |
| Correct answer |
Correct Answer
Semi-Correct Answer |