A Pediatric Case of Reversible Cerebral Vasoconstriction Syndrome With Similar Radiographic Findings to Posterior Reversible Encephalopathy Syndrome

• Published in: Pediatric neurology 2017-06, Vol.71, p.73-76
• Main Authors: Kamide, Tomoya, MD, PhD, Tsutsui, Taishi, MD, Misaki, Kouichi, MD, PhD, Sano, Hiroki, MD, PhD, Mohri, Masanao, MD, PhD, Uchiyama, Naoyuki, MD, PhD, Nakada, Mitsutoshi, MD, PhD
• Format: Article
• Language: English
• Subjects: Brain - diagnostic imaging; Cerebral Angiography; Cerebrovascular Disorders - diagnostic imaging; Child; Diagnosis, Differential; Diffusion Magnetic Resonance Imaging; Headache Disorders, Primary - diagnostic imaging; Humans; Magnetic Resonance Angiography; Male; Neurology; pediatric; Pediatrics; Posterior Leukoencephalopathy Syndrome - diagnostic imaging; posterior reversible encephalopathy syndrome; reversible cerebral vasoconstriction syndrome; thunderclap headache
• ISSN: 0887-8994; 1873-5150
• DOI: 10.1016/j.pediatrneurol.2017.02.008

Abstract Background Reversible cerebral vasoconstriction syndrome occurs predominantly in middle-aged women. Only nine pediatric cases of this syndrome have been reported. Patient Description We present a ten-year-old boy with reversible cerebral vasoconstriction syndrome with radiographic findings similar to those of posterior reversible encephalopathy syndrome (PRES). He presented with a thunderclap headache without a neurological deficit. Brain magnetic resonance angiography (MRA) revealed multifocal narrowing of the cerebral arteries, whereas magnetic resonance imaging (MRI) with diffusion-weighted imaging and fluid-attenuated inversion recovery demonstrated hyperintense lesions in the occipital lobes and the left cerebellum. The patient's symptoms resolved spontaneously after a few hours with no recurrence. MRA on the second day showed a complete normalization of the affected arteries, and MRI after one month demonstrated improvement in the abnormal findings, leading to a diagnosis of RCVS with radiographic findings similar to those of PRES. Conclusions This child's findings suggests that, RCVS, with or without PRES, may occur in children who present with a thunderclap headache.