Clinical manifestations and pathogenesis of reversible cerebral vasoconstriction syndrome

Abstract

The data of patients with reversible cerebral vasoconstriction syndrome (RCVS) who were examined and treated in 2013–2020 are presented. 136 patients were examined (37.3 ± 11.4 years) – 107 (78.7 %) women, 29 (21.3 %) men. Detailed neurological examination, magnetic resonance imaging of the brain, magnetic resonance angiography and magnetic resonance venography were performed. Results. Primary RCVS was detected in 29 (21.3%), secondary RCVS – in 69 patients (50.7%), and a combination of primary and secondary RCVS factors – in 38 (28.0%) patients. In 95 (69.8%) patients (80 women, 15 men; p < 0.05) signs of cerebral artery angiodysplasia were identified. Hypoplasia of venous sinuses (transverse and/or sigmoid) was found in 34 patients (29 women and 5 men). Conclusions. RCVS is developed in women more often than men, but there was no significant difference in risk factors between men and women. Predisposing factors of both primary and secondary RCVS can be revealed simultaneously. Women were more likely to have variants of brachiocephalic artery development. Clarification of angiodysplasia variant influence to the development and severity of RCVS requires further study.