Reversible Cerebral Vasoconstriction Syndrome associated to Cervical Artery Dissection: Two Cases and Review of the Literature.
Mario Ricciardi1, Maia Gomez Schneider2, Maria Agustina Ruiz Yanzi1, Oscar Garat1, Lucas Alessandro1, Daiana Dossi2, Virginia Pujol Lereis2, Sebastian Ameriso2
1Neurology, 2Vascular Neurology, Fleni
Objective:
The purpose of this study was to describe the association between Reversible Cerebral Vasoconstriction Syndrome (RCVS) and Cervical Artery Dissection (CAD) in two cases and to review the literature discussing potential explanations for the association.
Background:
RCVS and CAD are infrequent and potentially underdiagnosed pathological conditions. There are few case reports with simultaneous occurrence of both conditions. A potentially common underlying physiopathological mechanism is still unknown.
Design/Methods:
Retrospective study of consecutive cases of patients diagnosed with RCVS and/or CAD from January 2010 to June 2021 in a neurological institute in Buenos Aires, Argentina. Demographic, clinical, laboratory, and neuroimaging data were collected and reviewed. Possible predisposing factors, clinical course and treatment were also recorded. Literature review was performed using online search engine PubMed, until June 2021.
Results:
Seventy-three SVCR cases and 256 CAD cases were included. Only 2 patients had RCVS and CAD simultaneously. RCVS and CAD diagnosis in those two cases were made simultaneously. Both cases received treatment for CAD and RVCS and had good outcomes, without ischemic or hemorrhagic complications. These 2 cases add to 9 case reports and a case series of 20 patients published in the literature.
Conclusions:
The association between RCVS and CAD is infrequent and the pathophysiological mechanisms are still uncertain. Nonetheless, it is convenient to study intracranial and extracranial vasculature in all patients since the simultaneous diagnosis of these entities modifies the therapeutic plan and care.