Neurological Disorders

Post-Partum Reversible Cerebral Vasoconstriction Syndrome Associated with Coronary Vasospasm

Abstract

Georges Saab, Ryan Ghusayni and Johnny S Salameh

Objective: To report the first case of reversible cerebral vasoconstriction syndrome (RCVS) diagnosed when reversible cardiac wall motion akinesia was observed after the administration of atropine in a 28-year-old lady presenting 4 weeks post-partum with a 2-week history of thunderclap headache.
Case presentation: We present a case of a 28-year-old lady, who presented to the American University of Beirut Medical Center, with a history of migraine with visual auras and peri-partum pituitary hyperplasia, presenting 4 weeks postpartum with a 2-week history of thunderclap headache.
Results: RCVS comprises a group of diseases characterized by reversible focal segmental narrowing of cerebral vessels, usually accompanied by thunderclap headache and sometimes focal neurological deficits.
Conclusion: Several case reports and case series have described the association of this disorder with vascular manifestations outside the cerebral vasculature, including dissection of both external and internal branches of the carotid arteries, unruptured saccular berry aneurysms and fibromuscular dysplasia of the extracranial internal carotid artery (ICA). In this short report we describe a patient with reversible cerebral vasoconstriction associated with reversible cardiac wall abnormalities.