Reversible Cerebral Vasoconstriction Syndrome without Headache That Was Initially Suspected of Being Primary Angiitis of the Central Nervous System

• Published in: Internal Medicine Vol. 60; no. 14; pp. 2321 - 2326
• Main Authors: Matsubayashi, Taiki, Oniki, Ayako, Furuki, Misako, Obayashi, Masato
• Format: Journal Article
• Language: English
• Published: Tokyo The Japanese Society of Internal Medicine 15.07.2021; Japan Science and Technology Agency
• Subjects: Angiography; Arteries; Case Report; Central nervous system; Convulsions; Differential diagnosis; Headache; Headaches; Internal medicine; magnetic resonance angiography; Nervous system; primary angiitis of the central nervous system; reversible cerebral vasoconstriction syndrome; Stenosis; Vasculitis; Vasoconstriction
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.6560-20

A 48-year-old man had convulsions, and magnetic resonance angiography (MRA) showed diffuse constriction of the cerebral arteries. He was suspected of having primary angiitis of the central nervous system (PACNS) and treated with steroid for three days. The MRA abnormality disappeared after a week. After 69 days, he developed dizziness, and MRA revealed recurrence of cerebral artery stenosis. Nevertheless, the symptoms and abnormal MRA findings recovered promptly without treatment. He was diagnosed with reversible cerebral vasoconstriction syndrome (RCVS) without headache. This case suggests that RCVS should be a differential diagnosis in patients without headache whose MRA findings show multiple cerebral artery stenosis.