Short communication| Volume 276, ISSUE 1-2, P189-192, January 15, 2009

Download started.


Reversible cerebral vasoconstriction syndrome presenting with haemorrhage


      Reversible cerebral vasoconstriction syndromes are characterized by prolonged but reversible vasoconstriction of the cerebral arteries, presenting typically with thunderclap headache, with or without focal neurological signs or symptoms. They resemble primary central nervous system vasculitis but it is critical to differentiate these two entities. Here we draw attention to intracranial haemorrhage as an important and not uncommon clinical feature in reversible cerebral vasoconstriction syndrome. Four patients with reversible cerebral vasoconstriction syndrome, each presenting to a single unit with intracranial haemorrhage, are described. These descriptions of haemorrhage at presentation of RCVS extend the recognised clinical phenotype and so help to enhance recognition and diagnosis of this often unconsidered disorder.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of the Neurological Sciences
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Call G.K.
        • Fleming M.C.
        • Sealfon S.
        • Levine H.
        • Kistler J.P.
        • Fisher C.M.
        Reversible cerebral segmental vasoconstriction.
        Stroke. Sep 1988; 19: 1159-1170
        • Ducros A.
        • Boukobza M.
        • Porcher R.
        • Sarov M.
        • Valade D.
        • Bousser M.G.
        The clinical and radiological spectrum of reversible cerebral vasoconstriction syndrome. A prospective series of 67 patients.
        Brain. Dec 1 2007; 130: 3091-3101
        • Calabrese L.H.
        • Dodick D.W.
        • Schwedt T.J.
        • Singhal A.B.
        Narrative review: reversible cerebral vasoconstriction syndromes.
        Ann Intern Med. Jan 2 2007; 146: 34-44
        • Singhal A.B.
        • Caviness V.S.
        • Begleiter A.F.
        • Mark E.J.
        • Rordorf G.
        • Koroshetz W.J.
        Cerebral vasoconstriction and stroke after use of serotonergic drugs.
        Neurology. Jan 8 2002; 58: 130-133
        • Noskin O.
        • Jafarimojarrad E.
        • Libman R.B.
        • Nelson J.L.
        Diffuse cerebral vasoconstriction (Call–Fleming syndrome) and stroke associated with antidepressants.
        Neurology. Jul 11 2006; 67: 159-160
        • Nowak D.A.
        • Rodiek S.O.
        • Henneken S.
        • Zinner J.
        • Schreiner R.
        • Fuchs H.H.
        • et al.
        Reversible segmental cerebral vasoconstriction (Call–Fleming syndrome): are calcium channel inhibitors a potential treatment option?.
        Cephalalgia. Apr 2003; 23: 218-222
        • Lu S.R.
        • Liao Y.C.
        • Fuh J.L.
        • Lirng J.F.
        • Wang S.J.
        Nimodipine for treatment of primary thunderclap headache.
        Neurology. Apr 27 2004; 62: 1414-1416
        • Dodick D.W.
        Reversible segmental cerebral vasoconstriction (Call–Fleming syndrome): the role of calcium antagonists.
        Cephalalgia. Apr 2003; 23: 163-165
        • Moskowitz S.I.
        • Calabrese L.H.
        • Weil R.J.
        Benign angiopathy of the central nervous system presenting with intracerebral hemorrhage.
        Surg Neurol. May 2007; 67: 522-527
        • Joseph F.G.
        • Scolding N.J.
        Cerebral vasculitis — a practical approach.
        Practical Neurology. 2002; 2: 80-93
        • Scolding N.J.
        Cerebral vasculitis.
        in: Scolding NJ Immunological and inflammatory diseases of the central nervous system. Butterworth-Heinemann, Oxford1999: 210-258
        • Hajj-Ali R.A.
        • Furlan A.
        • bou-Chebel A.
        • Calabrese L.H.
        Benign angiopathy of the central nervous system: cohort of 16 patients with clinical course and long-term followup.
        Arthritis Rheum. Dec 15 2002; 47: 662-669
        • van Gijn J.
        Cerebral vasoconstriction, headache and sometimes stroke: one syndrome or many?.
        Brain. Dec 1 2007; 130: 3060-3062
        • Chen S.P.
        • Fuh J.L.
        • Lirng J.F.
        • Chang F.C.
        • Wang S.J.
        Recurrent primary thunderclap headache and benign CNS angiopathy: spectra of the same disorder?.
        Neurology. Dec 26 2006; 67: 2164-2169
        • Singhal A.B.
        Postpartum angiopathy with reversible posterior leukoencephalopathy.
        Arch Neurol. Mar 2004; 61: 411-416
        • Loewen A.H.
        • Hudon M.E.
        • Hill M.D.
        Thunderclap headache and reversible segmental cerebral vasoconstriction associated with use of oxymetazoline nasal spray.
        CMAJ. Sep 14 2004; 171: 593-594
        • Shah A.K.
        Non-aneurysmal primary subarachnoid hemorrhage in pregnancy-induced hypertension and eclampsia.
        Neurology. Jul 8 2003; 61: 117-120