A Case of Reversible Cerebral Vasoconstriction Syndrome: Postpartum Cerebral Angiopathy in a 32-Year-Old Primigravid Treated with Intravenous Immunoglobulin
| Autor: | Jose C. Navarro, John Angelo Luigi S. Perez, Geraldine Siena L. Mariano, Senna S. Lim, Manilen E. Dueñas |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
reversible cerebral vasoconstriction syndrome postpartum cerebral angiopathy Angiopathy Midbrain Internal medicine medicine cardiovascular diseases RC346-429 biology business.industry Cerebral infarction Vasospasm medicine.disease cerebral infarction Reversible cerebral vasoconstriction syndrome Pons Transcranial Doppler biology.protein Cardiology cardiovascular system Neurology (clinical) Neurology. Diseases of the nervous system Antibody business Single Case − General Neurology |
| Zdroj: | Case Reports in Neurology, Vol 13, Iss 3, Pp 620-627 (2021) Case Reports in Neurology |
| Popis: | This is a case of a 32-year-old primigravid who developed sudden severe headache on the 7th day postpartum associated with focal neurologic deficits and altered sensorium. She had a GCS score of 6, anisocoric pupils and an NIHSS score of 31. Cranial MRI with MRA showed multifocal hyperacute to acute infarcts on the left occipital lobe, left thalamus, and midbrain which was more prominent on the right. Due to clinical deterioration, a repeat Cranial MRI with MRA was done and showed progression of infarcts involving both thalami and right pons with interval appearance of contour irregularities in the proximal anterior cerebral, posterior cerebral, basilar and internal carotid arteries. Serial transcranial Doppler showed significant distal right middle cerebral artery vasospasm. She was managed as a case of reversible cerebral vasoconstriction syndrome, associated with postpartum cerebral angiopathy. Intravenous pulse methylprednisolone was started subsequently IVIG was initiated. Intravenous immunoglobulin was given for 5 days. The patient gradually improved, underwent rehabilitation therapy, and was discharged stable after 6 weeks. |
| Databáze: | OpenAIRE |
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