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Reversibelt cerebralt vasokonstriktionssyndrom. Akut huvudvärk som kan kompliceras av stroke och epileptiska anfall
Engelsk titel: Reversible cerebral vasoconstriction syndrome. Acute headache which can be complicated by stroke and epileptic seizures Läs online Författare: Edvardsson, Bengt ; Persson, Staffan Språk: Swe Antal referenser: 17 Dokumenttyp: Fallbeskrivning UI-nummer: 10091677


Läkartidningen 2010;107(35)2002-5 ISSN 0023-7205 E-ISSN 1652-7518 KIBs bestånd av denna tidskrift Denna tidskrift är expertgranskad (Peer-Reviewed)


Reversible cerebral vasoconstriction syndrome is a syndrome characterized by a sudden thunderclap-like headache, with or without focal neurological deficits and reversible vascular narrowing of the large and medium-sized cerebral arteries of the circle of Willis and its branches. The major complications are subarachnoid haemorrhage and parenchymal ischaemic or haemorrhagic strokes which may leave permanent sequelae. Multiple thunderclap headaches recurring every day over 1-4 weeks are typical. The condition is difficult to diagnose resulting in delayed diagnosis and it is also probably underdiagnosed. Diagnosis requires the demonstration of the “string of beads” appearance of cerebral arteries on angiography with complete resolution on repeat angiography 12 weeks after onset. Preferred investigations are CTA, MRA or catheter-based angiography. The differential diagnoses are primary angiitis of the central nervous system, aneurysmal subarachnoid haemorrhage and other causes of thunderclap headaches. Increased awareness of the syndrome is generally needed for doctors, in particular among stroke physicians.