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Case No. 423
2016-10-01~2016-10-31
출제자 : 차지훈
Hit : 377
| Period | 2016-10-01~2016-10-31 |
|---|---|
| Diagnosis | RCVS (reversible cerebral vasoconstriction syndrome) |
| Clinical information | F/52 C.C> thunderclap headache last image – f/u after 8 months |
| Discussion | Imaging findings - Multifocal stenosis of large to medium sized intracranial arteries with string of beads appearance - Reversible in follow up MR angiography Review - Group of disorders characterized by Thunderclap (severe, acute-onset) headache with or without focal neurological deficits, often recurrent Multifocal cerebral artery vasoconstrictions Resolve within 3 months - Pathology Transient disturbance in control of cerebral vascular tone vasoconstriction ischemia, stroke Spontaneous or precipitated by post-partum state, exposure to vasoactive substances - Imaging Involve large, medium-sized arteries Diffuse, multifocal, segmental narrowing (string of beads, sausage strings) Cortical SAH (20%), parenchymal hemorrhage, infarction PRES (posterior reversible encephalopathy syndrome) - Treatment Calcium channel blocker (e.g. nimodipine) |
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