Reversible cerebral vasoconstriction syndrome associated with probable drug poisoning

Reversible cerebral vasoconstriction syndrome (RCVS) is a clinical condition characterized by arterial involvement of the intracranial vessels, manifesting with vasospasm. The most common clinical manifestation related to the syndrome is the thunderclap headache, which consists of a severe headache...

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Published in:Radiology case reports 2023-03, Vol.18 (3), p.844-849
Main Authors: Veras, Arthur de Oliveira, Noleto, Felipe Micelli, Ribas, Michelle Zonkowski, Paticcié, Gabriela Ferreira, Palomo Barreira, Raphael, Correa, Beatriz Medeiros, Torres, Thomas Zurga Markus, Rossette, Vanessa Moraes, Miranda, Natalia Figueiredo, Miyahira, Clara Kimie, Claudino dos Santos, Júlio César
Format: Article
Language:English
Subjects:
Cannabinoid
Case Report
Headache
Marijuana
Reversible cerebral vasoconstriction syndrome
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Summary:Reversible cerebral vasoconstriction syndrome (RCVS) is a clinical condition characterized by arterial involvement of the intracranial vessels, manifesting with vasospasm. The most common clinical manifestation related to the syndrome is the thunderclap headache, which consists of a severe headache that reaches the peak of pain within minutes. The imaging study assumes a leading role in the complementary investigation. Laboratory tests and cerebrospinal fluid analysis are often nonspecific and without significant diagnostic importance. Non-contrast studies of the brain parenchyma reveal variable results that can often be normal. Angiographic findings, which initially may not reveal any changes, allow the visualization of diffuse narrowing of the vessels, with the posterior cerebral circulation being preferentially affected. The present study reports the case of a 19-year-old woman with no relevant medical history, except that she was a regular user of marijuana and a drug based on chloroform and ether. The patient showed clinical and imaging signs compatible with RCVS, and the narcotics used by her were considered precipitating factors.
ISSN:1930-0433
1930-0433
DOI:10.1016/j.radcr.2022.11.044