Filomena Caria1, Marialuisa Zedde2, Massimo Gamba3, Anna Bersano4, Maurizia Rasura5, Alessandro Adami6, Carlo Piantadosi7, Luca Quartuccio8, Cristiano Azzini9, Maurizio Melis10, Maria Luisa Delodovici11, Carlo Dallocchio12, Carlo Gandolfo13, Paolo Cerrato14, Cristina Motto15, Fabio Melis16, Alberto Chiti17, Mauro Gentile18, Valeria Bignamini19, Andrea Morotti20, Enrico Maria Lotti21, Antonella Toriello22, Paolo Costa23, Giorgio Silvestrelli24, Andrea Zini25, Valeria De Giuli1, Loris Poli1, Maurizio Paciaroni26, Corrado Lodigiani27, Simona Marcheselli28, Sandro Sanguigni29, Massimo Del Sette30, Serena Monaco31, Piergiorgio Lochner32, Carla Zanferrari33, Sabrina Anticoli34, Alessandro Padovani1, Alessandro Pezzini1. 1. 1 Dipartimento di Scienze Cliniche e Sperimentali, Clinica Neurologica, Università degli Studi di Brescia, Brescia, Italy. 2. 2 SC Neurologia, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy. 3. 3 Stroke Unit, Neurologia Vascolare, Spedali Civili di Brescia, Brescia, Italy. 4. 4 UO Malattie Cerebrovascolari, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Milan, Italy. 5. 5 Stroke Unit, Azienda Ospedaliera Sant'Andrea, Università "La Sapienza", Rome, Italy. 6. 6 Stroke Center, Dipartimento di Neurologia, Ospedale Sacro Cuore Negrar, Verona, Italy. 7. 7 UOC Neurologia, Azienda Ospedaliera "San Giovanni-Addolorata", Rome, Italy. 8. 8 Clinica di Reumatologia, Dipartimento di Area Medica, Azienda Ospedaliero-Universitaria "Santa Maria della Misericordia", Udine, Italy. 9. 9 UO di Neurologia, Dipartimento di Neuroscienze e Riabilitazione, Azienda Ospedaliero-Universitaria di Ferrara, Ferrara, Italy. 10. 10 SC Neurologia and Stroke Unit, Dipartimento Neuroscienze e Riabilitazione, Azienda Ospedaliera "G. Brotzu", Cagliari, Italy. 11. 11 Unità di Neurologia, Ospedale di Circolo, Università dell'Insubria, Varese, Italy. 12. 12 Dipartimento di Area Medica, UOC Neurologia, ASST Pavia, Voghera, Italy. 13. 13 Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili, Università di Genova, Genoa, Italy. 14. 14 Dipartimento di Neuroscienze, Stroke Unit, Università di Torino, Torino, Italy. 15. 15 Stroke Unit, Dipartmento di Scienze Neurologiche, Azienda Ospedaliera "Niguarda Ca' Granda", Milan, Italy. 16. 16 SS NeuroVascolare Ospedale Maria Vittoria, ASL Città di Torino, Torino, Italy. 17. 17 UO Neurologia, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy. 18. 18 UO Neurologia - Stroke Unit, Ospedale "Santa Maria della Misericordia", Rovigo, Italy. 19. 19 Stroke Unit, U.O Neurologia, Ospedale "S. Chiara", Trento, Italy. 20. 20 UC Malattie Cerebrovascolari, IRCCS Fondazione Mondino, Pavia, Italy. 21. 21 Unità Operativa Complessa Neurologia, AUSL Romagna, Ravenna, Italy. 22. 22 Unità Operativa Complessa Neurologia, Azienda Ospedaliera Universitaria "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy. 23. 23 UO Neurologia, Istituto Ospedaliero Poliambulanza, Brescia, Italy. 24. 24 Stroke Unit, Dipartimento di Neuroscienze, Ospedale Carlo Poma, Mantova, Italy. 25. 25 Stroke Unit, Clinica Neurologica, Nuovo Ospedale Civile "S. Agostino Estense", AUSL Modena, Italy. 26. 26 Stroke Unit and Divisione di Medicina Cardiovascolare, Università di Perugia, Italy. 27. 27 Centro Trombosi e Malattie Emorragiche, Humanitas Clinical and Research Center, IRCCS, Rozzano-Milano, Italy. 28. 28 Neurologia d'Urgenza and Stroke Unit, Humanitas Clinical and Research Center, IRCCS, Rozzano-Milano, Italy. 29. 29 Dipartmento di Neurologia, Ospedale "Madonna del Soccorso", San Benedetto del Tronto, Italy. 30. 30 Unità di Neurologia, E.O. Ospedali Galliera, Genova, Italy. 31. 31 Stroke Unit, Ospedale Civico, Palermo, Italy. 32. 32 Dipartimento di Neurologia, Saarland University Medical Center, Homburg, Germany. 33. 33 UOC Neurologia, ASST Melegnano-Martesana, Vizzolo Predabissi, Italy. 34. 34 Stroke Unit, Dipartimento di Emergenza-Urgenza, Ospedale "S. Camillo-Forlanini", Rome, Italy.
Abstract
INTRODUCTION: To describe clinical, neuroimaging, and laboratory features of a large cohort of Italian patients with reversible cerebral vasoconstriction syndrome. METHODS: In the setting of the multicenter Italian Project on Stroke at Young Age (IPSYS), we retrospectively enrolled patients with a diagnosis of definite reversible cerebral vasoconstriction syndrome according to the International Classification of Headache Disorders (ICHD)-3 beta criteria (6.7.3 Headache attributed to reversible cerebral vasoconstriction syndrome, imaging-proven). Clinical manifestations, neuroimaging, treatment, and clinical outcomes were evaluated in all patients. Characteristics of reversible cerebral vasoconstriction syndrome without typical causes ("idiopathic reversible cerebral vasoconstriction syndrome") were compared with those of reversible cerebral vasoconstriction syndrome related to putative causative factors ("secondary reversible cerebral vasoconstriction syndrome"). RESULTS: A total of 102 patients (mean age, 47.2 ± 13.9 years; females, 85 [83.3%]) qualified for the analysis. Thunderclap headache at presentation was reported in 69 (67.6%) patients, and it typically recurred in 42 (60.9%). Compared to reversible cerebral vasoconstriction syndrome cases related to putative etiologic conditions (n = 21 [20.6%]), patients with idiopathic reversible cerebral vasoconstriction syndrome (n = 81 [79.4%]) were significantly older (49.2 ± 13.9 vs. 39.5 ± 11.4 years), had more frequently typical thunderclap headache (77.8% vs. 28.6%) and less frequently neurological complications (epileptic seizures, 11.1% vs. 38.1%; cerebral infarction, 6.1% vs. 33.3%), as well as concomitant reversible brain edema (25.9% vs. 47.6%). CONCLUSIONS: Clinical manifestations and putative etiologies of reversible cerebral vasoconstriction syndrome in our series are slightly different from those observed in previous cohorts. This variability might be partly related to the coexistence of precipitating conditions with a putative etiologic role on disease occurrence.
INTRODUCTION: To describe clinical, neuroimaging, and laboratory features of a large cohort of Italian patients with reversible cerebral vasoconstriction syndrome. METHODS: In the setting of the multicenter Italian Project on Stroke at Young Age (IPSYS), we retrospectively enrolled patients with a diagnosis of definite reversible cerebral vasoconstriction syndrome according to the International Classification of Headache Disorders (ICHD)-3 beta criteria (6.7.3 Headache attributed to reversible cerebral vasoconstriction syndrome, imaging-proven). Clinical manifestations, neuroimaging, treatment, and clinical outcomes were evaluated in all patients. Characteristics of reversible cerebral vasoconstriction syndrome without typical causes ("idiopathic reversible cerebral vasoconstriction syndrome") were compared with those of reversible cerebral vasoconstriction syndrome related to putative causative factors ("secondary reversible cerebral vasoconstriction syndrome"). RESULTS: A total of 102 patients (mean age, 47.2 ± 13.9 years; females, 85 [83.3%]) qualified for the analysis. Thunderclap headache at presentation was reported in 69 (67.6%) patients, and it typically recurred in 42 (60.9%). Compared to reversible cerebral vasoconstriction syndrome cases related to putative etiologic conditions (n = 21 [20.6%]), patients with idiopathic reversible cerebral vasoconstriction syndrome (n = 81 [79.4%]) were significantly older (49.2 ± 13.9 vs. 39.5 ± 11.4 years), had more frequently typical thunderclap headache (77.8% vs. 28.6%) and less frequently neurological complications (epileptic seizures, 11.1% vs. 38.1%; cerebral infarction, 6.1% vs. 33.3%), as well as concomitant reversible brain edema (25.9% vs. 47.6%). CONCLUSIONS: Clinical manifestations and putative etiologies of reversible cerebral vasoconstriction syndrome in our series are slightly different from those observed in previous cohorts. This variability might be partly related to the coexistence of precipitating conditions with a putative etiologic role on disease occurrence.
Authors: A Bersano; M Kraemer; A Burlina; M Mancuso; J Finsterer; S Sacco; C Salvarani; L Caputi; H Chabriat; S Lesnik Oberstein; A Federico; E Tournier Lasserve; D Hunt; M Dichgans; M Arnold; S Debette; H S Markus Journal: J Neurol Date: 2020-04-21 Impact factor: 4.849
Authors: J M Sequeiros; J A Roa; R P Sabotin; S Dandapat; S Ortega-Gutierrez; E C Leira; C P Derdeyn; G Bathla; D M Hasan; E A Samaniego Journal: AJNR Am J Neuroradiol Date: 2020-09-17 Impact factor: 3.825
Authors: Ryan Daniel Gotesman; Naomi Niznick; Brian Dewar; Dean A Fergusson; Risa Shorr; Michel Shamy; Dar Dowlatshahi Journal: BMJ Open Date: 2020-09-21 Impact factor: 2.692