A pediatric case of reversible cerebral vasoconstriction syndrome with similar radiographical findings to posterior reversible encephalopathy syndrome

Publication date: Available online 20 February 2017
Source:Pediatric Neurology
Author(s): Tomoya Kamide, Taishi Tsutsui, Kouichi Misaki, Hiroki Sano, Masanao Mohri, Naoyuki Uchiyama, Mitsutoshi Nakada
BackgroundReversible cerebral vasoconstriction syndrome predominantly occurs in middle-aged women. Only 9 pediatric cases of this syndrome have ever been reported.Case reportHere we present a pediatric case of reversible cerebral vasoconstriction syndrome (RCVS) with similar radiographical findings to posterior reversible encephalopathy syndrome (PRES). A 10-year-old healthy boy developed thunderclap headache with no neurological deficit. Brain magnetic resonance angiography (MRA) revealed multifocal narrowing of the cerebral arteries, while magnetic resonance imaging (MRI) with diffusion-weighted imaging and fluid-attenuated inversion recovery demonstrated hyperintense lesions in the bilateral occipital lobes and the left cerebellum. The patient's clinical symptoms resolved spontaneously after a few hours and no recurrence was reported thereafter. MRA on the 2nd day showed a complete normalization of the affected arteries and MRI after 1 month demonstrated a significant improvement in the abnormal findings, leading to a diagnosis of RCVS with similar radiographical findings to PRES.ConclusionsThis report suggests that, although rare, RCVS with or without PRES, should be considered in pediatric patients if they present with a thunderclap headache.



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