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Idiopathic reversible segmental cerebral vasoconstriction

¹ Neurology Registrar
² Neurologist
³ Neurologist, Auckland City Hospital, Auckland, New Zealand

Correspondence to:
Correspondence to:
Dr F Miteff, Department of Neurology, Auckland City Hospital, 2 Park Road, Grafton, Auckland 1023, New Zealand;
ferdinandf@adhb.govt.nz

The first 150 words of the full text of this article appear below.

A 65 year old woman presented with recurrent, unprovoked thunderclap headaches over the previous five days. She was discharged after a normal CT brain scan and cerebrospinal fluid analysis (no xanthochromia). She represented five days later following abrupt onset of left arm and leg weakness, having had transient right leg weakness three days earlier. No weakness was found on admission, but she developed a left hemiplegia the same evening. Magnetic resonance (MR) imaging showed multifocal narrowing of the first and second order intracranial arteries and diffusion abnormalities involving more the right than the left anterior cerebral artery territories. She developed a left homonymous hemianopia two days later and repeat MR showed more extensive arterial narrowing (fig 1) and new diffusion abnormalities affecting her right posterior temporal region. A third MR seven days after starting oral nimodipine showed near complete resolution of the arterial abnormalities (fig 2). There was . . . [Full text of this article]