Læknablaðið - feb. 2020, Blaðsíða 31

LÆKNAblaðið 2020/106 83
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Heimildir

Reversible cerebral vasoconstriction is characterized by thund-
erclap headache and vasoconstriction of cerebral arteries, with
or without focal neurologic symptoms.
The syndrome is three times more common in women with
a mean age around 45 years. In approximately 60% of cases
a cause can be identified, commonly after intake of vasoact-
ive substances. The pathophysiology of reversible cerebral
vasoconstriction syndrome is unknown, though temporary
dysregulation in cerebral vascular tone is thought to be a key
underlying mechanism. The syndrome typically follows a ben-
ign course; however, complications such as ischemic stroke
or intracranial hemorrhage can cause permanent disability or
death in a small minority of patients. Vascular imaging reveals
alternating cerebral vasoconstriction and vasodilation that
normalizes within 12 weeks. Calcium channel antagonists
such as nimodipine reduce the frequency of thunderclap hea-
daches but do not decidedly affect the risk of cerebral ischemia
or hemorrhage. In this article the epidemiology, risk factors,
pathophysiology, symptoms, diagnosis and treatment of RCVS
is reviewed.
Reversible cerebral vasoconstriction syndrome
– a common cause of thunderclap headache
ENGLISH SUMMARY
1Department of Neurology, University Hospital of Iceland, 2Department of Radiology, University Hospital of Iceland, 3Department of Neurosurgery, University Hospital
of Iceland, Reykjavik, Iceland.
Key words: reversible cerebral vasoconstriction syndrome, RCVS, cerebral infarction, intracranial hemorrhage, thunderclap headache.
Correspondence: Ólafur Sveinsson, olafursv@landspitali.is
Ólafur Sveinsson1
Áskell Löve2
Vilhjálmur Vilmarsson2
Ingvar Ólafsson3
DOI: 10.17992/lbl.2020.02.374
Greinin barst til blaðsins 24. ágúst, samþykkt til birtingar 7. nóvember 2019.