Reversible Cerebral Vasoconstriction Syndrome Presenting with Transient Global Amnesia

• Published in: Internal Medicine Vol. 56; no. 12; pp. 1569 - 1573
• Main Authors: Isahaya, Kenji, Shinohara, Kensuke, Akamatu, Masashi, Shimizu, Takahiro, Sakurai, Kenzo, Shiraishi, Makoto, Akiyama, Hisanao, Hasegawa, Yasuhiro
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 01.01.2017; Japan Science and Technology Agency
• Subjects: Aged; Amnesia; Amnesia, Transient Global - complications; Aneurysms; Case Report; EEG; Headache; Headache Disorders, Primary; Hemorrhage; Humans; Internal medicine; Magnetic resonance imaging; Male; Neurological diseases; Posterior Cerebral Artery; reversible cerebral vasoconstriction syndrome; Subarachnoid hemorrhage; Subarachnoid Hemorrhage - diagnosis; Subarachnoid Hemorrhage - etiology; Syndrome; thunderclap headache; transient global amnesia; Vasoconstriction; reversible cerebral vasoconstriction syndrome; thunderclap headache; subarachnoid hemorrhage; transient global amnesia
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.56.7460

A 65-year-old man who had been diagnosed with transient global amnesia (TGA) 15 years previously was admitted to hospital with complaints of amnesia and headache. His symptoms improved on day-2. The initial brain MRI and electroencephalography findings were normal. He was diagnosed with a recurrence of TGA and discharged. However, he returned with right leg weakness and complained of a thunderclap headache. MRI demonstrated subarachnoid hemorrhage and multifocal segmental narrowing of the left posterior cerebral artery (PCA) and large intracranial arteries, and he was diagnosed with reversible cerebral vasoconstriction syndrome (RCVS). He was discharged on day-30 without any neurological deficits. This case suggested that TGA should be interpreted as one of the symptoms of RCVS or a prodromal symptom of RCVS.