Reversible cerebral vasoconstriction syndrome: a comprehensive systematic review
- 주제(키워드) Reversible cerebral vasoconstriction syndrome , Call-Fleming syndrome , Benign angiopathy of the central nervous system , Thunderclap headache , Reversible vasospasm , Migrainous vasospasm , Drug-induced cerebral arteritis , Postpartum cerebral angiopathy , Central nervous system pseudovasculitis
- 주제(기타) Pharmacology & Pharmacy
- 설명문(일반) [Song, T. J.] Ewha Womans Univ, Dept Neurol, Mokdong Hosp, Seoul, South Korea; [Lee, K. H.; Kim, J. Y.; Shin, J., I] Yonsei Univ, Dept Pediat, Coll Med, Seoul, South Korea; [Li, H.] Univ Florida, Coll Med, Gainesville, FL USA; [Chang, K.] Monash Univ, Cent Clin Sch, Fac Med Nursing & Hlth Sci, Melbourne, Vic, Australia; [Kim, S. H.] Pusan Natl Univ, Dept Pediat, Childrens Hosp, Yangsan, South Korea; [Han, K. H.] Jeju Natl Univ, Dept Pediat, Sch Med, Jeju, South Korea; [Kim, B. Y.] Ewha Womans Univ, Coll Med, Seoul, South Korea; [Kronbichler, A.] Med Univ Innsbruck, Dept Internal Med 4, Innsbruck, Austria; [Ducros, A.] Montpellier Univ Hosp, Dept Neurol, Montpellier, France; [Koyanagi, A.; Jacob, L.] Univ Barcelona, Fdn St Joan Deu, Parc Sanitari St Joan Deu, CIBERSAM, Barcelona, Spain; [Koyanagi, A.] ICREA, Lluis Companys 23, Barcelona, Spain; [Jacob, L.] Univ Versailles St Ouentin Yvelines, Fac Med, Montigny Le Bretonneux, France; [KiM, M. S.] Korea Univ, Coll Med, Seoul, South Korea; [KiM, M. S.] Cheongsan Publ Hlth Ctr, Minist Hlth & Welf, Wando, South Korea; [Yon, D. K.] CHA Univ, CHA Bundang Med Ctr, Dept Pediat, Sch Med, Seongnam, South Korea; [Lee, S. W.] Sejong Univ, Dept Data Sci, Coll Software Convergence, Seoul, South Korea; [Yang, J. M.] Univ Ulsan, Asan Med Ctr, Dept Ophthalmol, Coll Med, Seoul, South Korea; [Hong, S. H.; Ghayda, R. A.] Harvard TH Chan Sch Publ Hlth, Dept Global Hlth & Populat, Boston, MA USA; [Hong, S. H.] Yonsei Univ, Coll Med, Seoul, South Korea; [Ghayda, R. A.] Brigham & Womens Hosp, Div Urol, Boston, MA USA; [Ghayda, R. A.] Harvard Med Sch, Boston, MA 02115 USA; [Kang, J. W.] Chungnam Natl Univ, Dept Pediat, Coll Med, Daejeon, South Korea; [Smith, L.] Anglia Ruskin Univ, Cambridge Ctr Sport & Exercise Sci, Cambridge, England
- 등재 SCIE, SCOPUS
- 발행기관 VERDUCI PUBLISHER
- 발행년도 2021
- 총서유형 Journal
- URI http://www.dcollection.net/handler/ewha/000000181590
- 본문언어 영어
- Published As http://dx.doi.org/10.26355/eurrev_202105_25834
초록/요약
OBJECTIVE: We aimed to analyze clinical characteristics, treatment patterns, and prognosis of patients with reversible cerebral vasoconstriction syndrome (RCVS). MATERIALS AND METHODS: Two investigators independently searched PubMed and EM-BASE, and 191 cases were included in this study. Information regarding demographics, triggering factors, brain imaging findings, treatment modalities, recurrence, and clinical outcome was collected. RESULTS: The mean age of the patients was 39.9 years, and 155 (81.2%) were female. The most common triggering factor for RCVS was an exposure to vasoactive substances (41.4%), followed by pregnancy/postpartum (20.9%), and sexual intercourse (10.5%). Multifocal stenosis (84.0%) and beading shape (82.4%) were the leading abnormal findings on angiography, while cerebral ischemic lesions (47.6%) and cerebral hemorrhage (mainly subarachnoid hemorrhage) (35.1%) were the main findings on brain computed tomography (CT)/magnetic resonance imaging (MRI). Calcium channel blockers (nimodipine/verapamil) were the most commonly used medications (44.5%) in the treatment of RCVS. Multivariate analysis identified that RCVS was precipitated by trauma/surgery/procedure (hazard ratio (HR): 3.29, 95% confidence interval (CI) (1.21-8.88), p=0.019), and presence of aphasia/neglect/apraxia during the acute phase of the disease (HR: 3.83, 95% CI (1.33-11.05), p=0.013) were found to be the two independent risk factors for residual neurological deficit after RCVS. CONCLUSIONS: In our systematic review, vasoactive substances were the most frequent triggers for RCVS, which was most commonly accompanied by angiographic findings of multifocal stenotic lesions. Patients with RCVS precipitated by trauma or surgical procedures and those with focal cortical deficits had a higher risk of residual neurological deficits, and these patients should closely be monitored.
more