Le syndrome de vasoconstriction cérébrale réversible en 2017

Reversible cerebral vasoconstriction syndrome associates severe headache, mostly recurrent thunderclap headaches, and segmental constriction of cerebral arteries that resolve within three months. It is attributed to a transient disturbance in the control of cerebral vascular tone, with a globally favorable outcome. However, cerebral edema, intracranial hemorrhage or cerebral infarction may occur from onset or after a phase of isolated headache. Early management may help to avoid such complications. Diagnosis may be difficult when initial angiography is normal, which occurs in 20 % of cases because vasoconstriction scores peak 2 to 3 weeks after clinical onset. More than half the cases occur after exposure to adrenergic or serotoninergic substances or postpartum. Management is based on removal of any vasoactive substances, rest, and blood-pressure monitoring. Nimodipine seems to reduce headaches, but does not completely prevent stroke.