A case report on concomitant Reversible Cerebral Vasoconstriction Syndrome and Transient Global Amnesia

Reversible Cerebral Vasoconstriction Syndrome [RCVS] is an important differential diagnosis in patients with thunderclap headache. RCVS describes a rare pathological cerebrovascular condition in which vasoconstriction occurs, resulting in transient multifocal cerebral artery caliber changes as seen on imaging studies [Cappelen-Smith, Calic & Cordato, 2017; Ji, Jung, Yoo, Son & Kim, 2019]. The disease most commonly presents in middle-aged women and is usually characterized by a monophasic course with acute, frequently recurrent thunderclap headaches that may be accompanied by neurological deficits. While RCVS is often associated with a favorable prognosis, severe complications such as epileptic seizures, ischemic or hemorrhagic stroke and subarachnoid hemorrhage [SAH] can occur in some cases [Cappelen- Smith et al. 2017; Burton & Bushnell, 2019]. To establish the diagnosis of RCVS, other vascular conditions that cause a similar clinical and morphological pattern, including but not limited to aneurysmatic pathologies and primary angiitis of the central nervous system [PACNS], must be excluded [Burton et al. 2019; Boitet et al. 2020]. Currently, a few case studies discuss a pathophysiological association between RCVS and Transient Global Amnesia [TGA] [Boitet et al. 2020]. TGA is a benign neurological disorder characterized by sudden anterograde and variable retrograde amnesia without other accompanying neurological deficits. Typically, the amnesia resolves after a duration of twenty-four hours. An additional characteristic feature of TGA is the potential presence of hippocampal lesions, which are generally detected by Diffusion-Weighted Imaging [DWI] in Magnetic Resonance Imaging [MRI] scans with some delay ranging from twenty-four hours up to three days following the preceding episode [Spiegel et al. 2017; Yi et al. 2019; Taheri & Peters, 2022]. The exact pathophysiological mechanisms involved in TGA and RCVS remain unknown, but because of similar causative factors the two conditions may share overlapping biological mechanisms [Boitet et al. 2020; Yi et al. 2019]. In this case report we present a patient with consecutive clinical presentation of TGA and RCVS.

Comments (0)

No login
gif