Синдром обратимой церебральной вазоконстрикции

Кулеш А.А., Демин Д.А., Старикова Н.Л., Мехряков С.А., Кайлева Н.А. Синдром обратимой церебральной вазоконстрикции. Consilium Medicum. 2025;27(2):63–69. DOI: 10.26442/20751753.2025.2.203150

© ООО «КОНСИЛИУМ МЕДИКУМ», 2025 г.

________________________________________________

Kulesh AA, Demin DA, Starikova NL, Mekhryakov SA, Kayleva NA. Reversible cerebral vasoconstriction syndrome: A review. Consilium Medicum. 2025;27(2):63–69. DOI: 10.26442/20751753.2025.2.203150

Читать PDF

Аннотация

Синдром обратимой церебральной вазоконстрикции − важная, но плохо распознаваемая причина ишемического инсульта у молодых пациентов. Синдром следует заподозрить при наличии рецидивирующей (особенно громоподобной) головной боли в сочетании с очаговым неврологическим дефицитом, эпилептическими припадками или изменением психического статуса, а также важно активно собирать анамнез на предмет наличия вазоактивных триггеров. Радиологический спектр синдрома обратимой церебральной вазоконстрикции широк и включает инфаркты, внутримозговые и субарахноидальные кровоизлияния, а также заднюю обратимую энцефалопатию. Развитие данных паттернов может разворачиваться на протяжении первых 2 нед, что требует динамического проведения нейровизуализации, а к ранним признакам относится гиперинтенсивность артерий на FLAIR. Для верификации необходимо отсроченное выполнение ангиографии в динамике с демонстрацией обратимой мультифокальной сегментарной вазоконстрикции.

Ключевые слова: синдром обратимой церебральной вазоконстрикции, громоподобная головная боль, инсульт в молодом возрасте

________________________________________________

Reversible cerebral vasoconstriction syndrome is a relevant but poorly recognized cause of ischemic stroke in young patients. The syndrome should be suspected in patients with recurrent headaches (especially thunderclap headaches) associated with focal neurological deficits, epileptic seizures, or changes in mental status; taking history for any vasoactive triggers is crucial. The radiological spectrum of reversible cerebral vasoconstriction syndrome is broad and includes infarctions, intracerebral and subarachnoid hemorrhages, as well as posterior reversible encephalopathy. These patterns can unfold during the first 2 weeks, which requires serial neuroimaging; early signs include hyperintensity of the arteries on FLAIR. Delayed serial angiography showing reversible multifocal segmental vasoconstriction is required for verification.

Keywords: reversible cerebral vasoconstriction syndrome, thunderclap headache, stroke at a young age

Полный текст

Материалы доступны только для специалистов сферы здравоохранения.
Чтобы посмотреть материал полностью Авторизуйтесь или зарегистрируйтесь.

Список литературы

1. Ducros A. Reversible cerebral vasoconstriction syndrome. Lancet Neurol. 2012;11(10):906-17. DOI:10.1016/S1474-4422(12)70135-7
2. Call GK, Fleming MC, Sealfon S, et al. Reversible cerebral segmental vasoconstriction. Stroke. 1988;19(9):1159-70. DOI:10.1161/01.str.19.9.1159
3. Calabrese LH, Dodick DW, Schwedt TJ, Singhal AB. Narrative review: reversible cerebral vasoconstriction syndromes. Ann Intern Med. 2007;146(1):34-44. DOI:10.7326/0003-4819-146-1-200701020-00007
4. Singhal AB. Posterior Reversible Encephalopathy Syndrome and Reversible Cerebral Vasoconstriction Syndrome as Syndromes of Cerebrovascular Dysregulation. Continuum (Minneap Minn). 2021;27(5):1301-1320. DOI:10.1212/CON.0000000000001037
5. Song TJ, Lee KH, Li H, et al. Reversible cerebral vasoconstriction syndrome: a comprehensive systematic review. Eur Rev Med Pharmacol Sci. 2021;25(9):3519-29. DOI:10.26355/eurrev_202105_25834
6. Ducros A, Wolff V. The Typical Thunderclap Headache of Reversible Cerebral Vasoconstriction Syndrome and its Various Triggers. Headache. 2016;56(4):657-73. DOI:10.1111/head.12797
7. Cheng YC, Kuo KH, Lai TH. A common cause of sudden and thunderclap headaches: reversible cerebral vasoconstriction syndrome. J Headache Pain. 2014;15(1):13. DOI:10.1186/1129-2377-15-13
8. Ferrante E, Tassorelli C, Rossi P, et al. Focus on the management of thunderclap headache: from nosography to treatment. J Headache Pain. 2011;12:251-258
9. Yeh YC, Fuh JL, Chen SP, Wang SJ. Clinical features, imaging findings and outcomes of headache associated with sexual activity. Cephalalgia. 2010;30(11):1329-35. DOI:10.1177/0333102410364675
10. Bahra A. Other primary headaches-thunderclap-, cough-, exertional-, and sexual headache. J Neurol. 2020;267(5):1554-66. DOI:10.1007/s00415-020-09728-0
11. Erhart DK, Ludolph AC, Althaus K. RCVS: by clinicians for clinicians-a narrative review. J Neurol. 2023;270(2):673-88. DOI:10.1007/s00415-022-11425-z
12. The International Classification of headache disorders, 3rd edition. Cephalalgia. 2018;38(1):1-211. DOI:10.1177/0333102417738202
13. Старикова Н.Л. Громоподобная головная боль: диагностика и лечебная тактика. Российский журнал боли. 2016;3-4:3-7 [Starikova NL. Gromopodobnaia golovnaia bol: diagnostika i lechebnaia taktika. Rossiiskii zhurnal boli. 2016;3-4:3-7 (in Russian)].
14. Wolff V, Armspach JP, Lauer V, et al. Ischaemic strokes with reversible vasoconstriction and without thunderclap headache: a variant of the reversible cerebral vasoconstriction syndrome? Cerebrovasc Dis. 2015;39(1):31-8. DOI:10.1159/000369776.
15. Ekker MS, Verhoeven JI, Schellekens MMI, et al. Risk Factors and Causes of Ischemic Stroke in 1322 Young Adults. Stroke. 2023;54(2):439-47.
16. Kaufmann J, Buecke P, Meinel T, et al. Frequency of ischaemic stroke and intracranial haemorrhage in patients with reversible cerebral vasoconstriction syndrome (RCVS) and posterior reversible encephalopathy syndrome (PRES) – A systematic review. Eur J Neurol. 2024;31(5):e16246. DOI:10.1111/ene.16246.
17. Chen SP, Wang SJ. Pathophysiology of reversible cerebral vasoconstriction syndrome. J Biomed Sci. 2022;29(1):72. DOI:10.1186/s12929-022-00857-4.
18. Seok HY, Eun MY, Kim S, et al. Reversible cerebral vasoconstriction syndrome in Guillain-Barre syndrome: a case report and literature review. Neurol Sci. 2024;45(1):101-7. DOI:10.1007/s10072-023-07061-8.
19. Гудкова В.В., Кимельфельд Е.И., Стаховская Л.В. Малоизвестный синдром задней обратимой энцефалопатии, требующий неотложной помощи. Consilium Medicum. 2018;20(2):84-9 [Gudkova VV, Kimelfeld EI, Stakhovskaya LV. Under-reported posterior reversible encephalopathy syndrome that requires emergency management. Consilium Medicum. 2018;20(2):84-9 (in Russian)]. DOI:10.26442/2075-1753_2018.2.84-89
20. Wolff V, Ducros A. Reversible Cerebral Vasoconstriction Syndrome Without Typical Thunderclap Headache. Headache. 2016;56(4):674-87. DOI:10.1111/head.12794
21. Cappelen-Smith C, Calic Z, Cordato D. Reversible Cerebral Vasoconstriction Syndrome: Recognition and Treatment. Curr Treat Options Neurol. 2017;19(6):21. DOI:10.1007/s11940-017-0460-7
22. Lin PT, Chen SP, Wang SJ. Update on primary headache associated with sexual activity and primary thunderclap headache. Cephalalgia. 2023;43(3):3331024221148657. DOI:10.1177/03331024221148657
23. Ducros A, Boukobza M, Porcher R, et al. The clinical and radiological spectrum of reversible cerebral vasoconstriction syndrome. A prospective series of 67 patients. Brain. 2007;130(Pt 12):3091-101. DOI:10.1093/brain/awm256
24. Mawet J, Debette S, Bousser MG, Ducros A. The Link Between Migraine, Reversible Cerebral Vasoconstriction Syndrome and Cervical Artery Dissection. Headache. 2016;56(4):645-56. DOI:10.1111/head.12798
25. Pilato F, Distefano M, Calandrelli R. Posterior Reversible Encephalopathy Syndrome and Reversible Cerebral Vasoconstriction Syndrome: Clinical and Radiological Considerations. Front Neurol. 2020;11:34. DOI:10.3389/fneur.2020.00034
26. Кулеш А.А., Демин Д.А., Виноградов О.И. Цервикальная диссекция в экстренной неврологии: алгоритмы диагностики и лечения. Российский неврологический журнал. 2022;27(4):86-96 [Kulesh AA, Demin DA, Vinogradov OI. Cervical dissection in emergency neurology: diagnostic and treatment algorithms. Russian neurological journal. 2022;27(4):86-96 (in Russian)].
27. Perillo T, Paolella C, Perrotta G, et al. Reversible cerebral vasoconstriction syndrome: review of neuroimaging findings. Radiol Med. 2022;127(9):981-90. DOI:10.1007/s11547-022-01532-2
28. Burton TM, Bushnell CD. Reversible Cerebral Vasoconstriction Syndrome. Stroke. 2019;50(8):2253-8. DOI:10.1161/STROKEAHA.119.024416
29. Sivagurunathan GM, Khan A, Fotopoulos D. Radiological Findings in Reversible Cerebral Vasoconstriction Syndrome: A Systematic Review of Literature. Cureus. 2024;16(5):e59595. DOI:10.7759/cureus.59595
30. Chen SP, Fuh JL, Lirng JF, Wang SJ. Hyperintense vessels on flair imaging in reversible cerebral vasoconstriction syndrome. Cephalalgia. 2012;32(4):271-8. DOI:10.1177/0333102412437387
31. Murase S, Gon Y, Watanabe A, et al. Isolated cortical vasogenic edema and hyperintense vessel signs may be early features of reversible cerebral vasoconstriction syndrome: Case reports. Cephalalgia. 2018;38(6):1207-10. DOI:10.1177/0333102417731779
32. Kameda T, Namekawa M, Shimazaki H, et al. Unique combination of hyperintense vessel sign on initial FLAIR and delayed vasoconstriction on MRA in reversible cerebral vasoconstriction syndrome: a case report. Cephalalgia. 2014;34(13):1093-6. DOI:10.1177/0333102414529197
33. Itsekson-Hayosh Z, Tsarfaty G, Greenberg G, et al. Early Fluid Attenuation Inversion Recovery Sulcal Contrast Enhancement Correlates with Severity of Reversible Cerebral Vasoconstriction Syndrome. J Stroke. 2021;23(1):146. DOI:10.5853/jos.2020.01004.e1
34. Singhal AB, Hajj-Ali RA, Topcuoglu MA, et al. Reversible cerebral vasoconstriction syndromes: analysis of 139 cases. Arch Neurol. 2011;68(8):1005-12. DOI:10.1001/archneurol.2011.68
35. Ducros A, Fiedler U, Porcher R, et al. Hemorrhagic manifestations of reversible cerebral vasoconstriction syndrome: frequency, features, and risk factors. Stroke. 2010;41(11):2505-11. DOI:10.1161/STROKEAHA.109.572313
36. Noguchi S, Miyaoka R, Miyachi H. Clinical Images: Symmetrical Gyriform Restricted Diffusion in Severe Reversible Cerebral Vasoconstriction Syndrome. World Neurosurg. 2023;177:86-7. DOI:10.1016/j.wneu.2023.06.042
37. Strunk D, Veltkamp R, Meuth SG, et al. Intra-arterial application of nimodipine in reversible cerebral vasoconstriction syndrome: a neuroradiological method to help differentiate from primary central nervous system vasculitis. Neurol Res Pract. 2022;4(1):8. DOI:10.1186/s42466-022-00173-0
38. Sequeiros JM, Roa JA, Sabotin RP, et al. Quantifying Intra-Arterial Verapamil Response as a Diagnostic Tool for Reversible Cerebral Vasoconstriction Syndrome. AJNR Am J Neuroradiol. 2020;41(10):1869-75.
39. Merli N, Padroni M, Azzini C, et al. Reversible cerebral vasoconstriction syndrome: strategies to early diagnosis and the role of transcranial color-coded doppler ultrasonography (TCCD). Neurol Sci. 2023;44(7):2541-5. DOI:10.1007/s10072-023-06755-3
40. Hathidara M, Patel NH, Flores A, et al. Transcranial Doppler findings in reversible cerebral vasoconstriction syndrome. J Neuroimaging. 2022;32(2):345-51. DOI:10.1111/jon.12946
41. Robba C, Taccone FS. How I use Transcranial Doppler. Crit Care. 2019 Dec 23;23(1):420. DOI:10.1186/s13054-019-2700-6
42. Sharma VK, Tsivgoulis G, Lao AY, et al. Noninvasive detection of diffuse intracranial disease. Stroke. 2007;38(12):3175-81.
43. Кулеш А.А. Церебральный венозный тромбоз и его геморрагические осложнения. Неврология, нейропсихиатрия, психосоматика. 2021;13(2):10-8 [Kulesh AA. Cerebral venous thrombosis and its hemorrhagic complications. Neurology, Neuropsychiatry, Psychosomatics. 2021;13(2):10-8 (in Russian)].
44. Кулеш А.А., Демин Д.А., Гусева А.Л., и др. Вестибулярное головокружение в неотложной неврологии. Российский неврологический журнал. 2021;26(4):50-9 [Kulesh AA, Dyomin DA, Guseva AL, et al. Vestibular vertigo in emergency neurology. Russian neurological journal. 2021;26(4):50-9 (in Russian)].
45. Edlow JA, Newman-Toker DE, Savitz SI. Diagnosis and initial management of cerebellar infarction. Lancet Neurol. 2008;7(10):951-64. DOI:10.1016/S1474-4422(08)70216-3
46. Barkhoudarian G, Kelly DF. Pituitary Apoplexy. Neurosurg Clin N Am. 2019;30(4):457-63. DOI:10.1016/j.nec.2019.06.001
47. Cho S, Lee MJ, Chung CS. Effect of Nimodipine Treatment on the Clinical Course of Reversible Cerebral Vasoconstriction Syndrome. Front Neurol. 2019;10:644. DOI:10.3389/fneur.2019.00644.
48. Avola G, Pezzini A. Treatment-Related Reversible Cerebral Vasoconstriction Syndrome. J Clin Med. 2024;13(19):5930. DOI:10.3390/jcm13195930.
49. Elstner M, Linn J, Müller-Schunk S, Straube A. Reversible cerebral vasoconstriction syndrome: a complicated clinical course treated with intra-arterial application of nimodipine. Cephalalgia. 2009;29(6):677-82. DOI:10.1111/j.1468-2982.2008.01768.x
50. Ospel JM, Wright CH, Jung R, et al. Intra-Arterial Verapamil Treatment in Oral Therapy-Refractory Reversible Cerebral Vasoconstriction Syndrome. AJNR Am J Neuroradiol. 2020;41(2):293-9. DOI:10.3174/ajnr.A6378.
51. Singhal AB, Topcuoglu MA. Glucocorticoid-associated worsening in reversible cerebral vasoconstriction syndrome. Neurology. 2017;88(3):228-36. DOI:10.1212/WNL.0000000000003510

________________________________________________

1. Ducros A. Reversible cerebral vasoconstriction syndrome. Lancet Neurol. 2012;11(10):906-17. DOI:10.1016/S1474-4422(12)70135-7
2. Call GK, Fleming MC, Sealfon S, et al. Reversible cerebral segmental vasoconstriction. Stroke. 1988;19(9):1159-70. DOI:10.1161/01.str.19.9.1159
3. Calabrese LH, Dodick DW, Schwedt TJ, Singhal AB. Narrative review: reversible cerebral vasoconstriction syndromes. Ann Intern Med. 2007;146(1):34-44. DOI:10.7326/0003-4819-146-1-200701020-00007
4. Singhal AB. Posterior Reversible Encephalopathy Syndrome and Reversible Cerebral Vasoconstriction Syndrome as Syndromes of Cerebrovascular Dysregulation. Continuum (Minneap Minn). 2021;27(5):1301-1320. DOI:10.1212/CON.0000000000001037
5. Song TJ, Lee KH, Li H, et al. Reversible cerebral vasoconstriction syndrome: a comprehensive systematic review. Eur Rev Med Pharmacol Sci. 2021;25(9):3519-29. DOI:10.26355/eurrev_202105_25834
6. Ducros A, Wolff V. The Typical Thunderclap Headache of Reversible Cerebral Vasoconstriction Syndrome and its Various Triggers. Headache. 2016;56(4):657-73. DOI:10.1111/head.12797
7. Cheng YC, Kuo KH, Lai TH. A common cause of sudden and thunderclap headaches: reversible cerebral vasoconstriction syndrome. J Headache Pain. 2014;15(1):13. DOI:10.1186/1129-2377-15-13
8. Ferrante E, Tassorelli C, Rossi P, et al. Focus on the management of thunderclap headache: from nosography to treatment. J Headache Pain. 2011;12:251-258
9. Yeh YC, Fuh JL, Chen SP, Wang SJ. Clinical features, imaging findings and outcomes of headache associated with sexual activity. Cephalalgia. 2010;30(11):1329-35. DOI:10.1177/0333102410364675
10. Bahra A. Other primary headaches-thunderclap-, cough-, exertional-, and sexual headache. J Neurol. 2020;267(5):1554-66. DOI:10.1007/s00415-020-09728-0
11. Erhart DK, Ludolph AC, Althaus K. RCVS: by clinicians for clinicians-a narrative review. J Neurol. 2023;270(2):673-88. DOI:10.1007/s00415-022-11425-z
12. The International Classification of headache disorders, 3rd edition. Cephalalgia. 2018;38(1):1-211. DOI:10.1177/0333102417738202
13. Starikova NL. Gromopodobnaia golovnaia bol: diagnostika i lechebnaia taktika. Rossiiskii zhurnal boli. 2016;3-4:3-7 (in Russian).
14. Wolff V, Armspach JP, Lauer V, et al. Ischaemic strokes with reversible vasoconstriction and without thunderclap headache: a variant of the reversible cerebral vasoconstriction syndrome? Cerebrovasc Dis. 2015;39(1):31-8. DOI:10.1159/000369776.
15. Ekker MS, Verhoeven JI, Schellekens MMI, et al. Risk Factors and Causes of Ischemic Stroke in 1322 Young Adults. Stroke. 2023;54(2):439-47.
16. Kaufmann J, Buecke P, Meinel T, et al. Frequency of ischaemic stroke and intracranial haemorrhage in patients with reversible cerebral vasoconstriction syndrome (RCVS) and posterior reversible encephalopathy syndrome (PRES) – A systematic review. Eur J Neurol. 2024;31(5):e16246. DOI:10.1111/ene.16246.
17. Chen SP, Wang SJ. Pathophysiology of reversible cerebral vasoconstriction syndrome. J Biomed Sci. 2022;29(1):72. DOI:10.1186/s12929-022-00857-4.
18. Seok HY, Eun MY, Kim S, et al. Reversible cerebral vasoconstriction syndrome in Guillain-Barre syndrome: a case report and literature review. Neurol Sci. 2024;45(1):101-7. DOI:10.1007/s10072-023-07061-8.
19. Gudkova VV, Kimelfeld EI, Stakhovskaya LV. Under-reported posterior reversible encephalopathy syndrome that requires emergency management. Consilium Medicum. 2018;20(2):84-9 (in Russian). DOI:10.26442/2075-1753_2018.2.84-89
20. Wolff V, Ducros A. Reversible Cerebral Vasoconstriction Syndrome Without Typical Thunderclap Headache. Headache. 2016;56(4):674-87. DOI:10.1111/head.12794
21. Cappelen-Smith C, Calic Z, Cordato D. Reversible Cerebral Vasoconstriction Syndrome: Recognition and Treatment. Curr Treat Options Neurol. 2017;19(6):21. DOI:10.1007/s11940-017-0460-7
22. Lin PT, Chen SP, Wang SJ. Update on primary headache associated with sexual activity and primary thunderclap headache. Cephalalgia. 2023;43(3):3331024221148657. DOI:10.1177/03331024221148657
23. Ducros A, Boukobza M, Porcher R, et al. The clinical and radiological spectrum of reversible cerebral vasoconstriction syndrome. A prospective series of 67 patients. Brain. 2007;130(Pt 12):3091-101. DOI:10.1093/brain/awm256
24. Mawet J, Debette S, Bousser MG, Ducros A. The Link Between Migraine, Reversible Cerebral Vasoconstriction Syndrome and Cervical Artery Dissection. Headache. 2016;56(4):645-56. DOI:10.1111/head.12798
25. Pilato F, Distefano M, Calandrelli R. Posterior Reversible Encephalopathy Syndrome and Reversible Cerebral Vasoconstriction Syndrome: Clinical and Radiological Considerations. Front Neurol. 2020;11:34. DOI:10.3389/fneur.2020.00034
26. Kulesh AA, Demin DA, Vinogradov OI. Cervical dissection in emergency neurology: diagnostic and treatment algorithms. Russian neurological journal. 2022;27(4):86-96 (in Russian).
27. Perillo T, Paolella C, Perrotta G, et al. Reversible cerebral vasoconstriction syndrome: review of neuroimaging findings. Radiol Med. 2022;127(9):981-90. DOI:10.1007/s11547-022-01532-2
28. Burton TM, Bushnell CD. Reversible Cerebral Vasoconstriction Syndrome. Stroke. 2019;50(8):2253-8. DOI:10.1161/STROKEAHA.119.024416
29. Sivagurunathan GM, Khan A, Fotopoulos D. Radiological Findings in Reversible Cerebral Vasoconstriction Syndrome: A Systematic Review of Literature. Cureus. 2024;16(5):e59595. DOI:10.7759/cureus.59595
30. Chen SP, Fuh JL, Lirng JF, Wang SJ. Hyperintense vessels on flair imaging in reversible cerebral vasoconstriction syndrome. Cephalalgia. 2012;32(4):271-8. DOI:10.1177/0333102412437387
31. Murase S, Gon Y, Watanabe A, et al. Isolated cortical vasogenic edema and hyperintense vessel signs may be early features of reversible cerebral vasoconstriction syndrome: Case reports. Cephalalgia. 2018;38(6):1207-10. DOI:10.1177/0333102417731779
32. Kameda T, Namekawa M, Shimazaki H, et al. Unique combination of hyperintense vessel sign on initial FLAIR and delayed vasoconstriction on MRA in reversible cerebral vasoconstriction syndrome: a case report. Cephalalgia. 2014;34(13):1093-6. DOI:10.1177/0333102414529197
33. Itsekson-Hayosh Z, Tsarfaty G, Greenberg G, et al. Early Fluid Attenuation Inversion Recovery Sulcal Contrast Enhancement Correlates with Severity of Reversible Cerebral Vasoconstriction Syndrome. J Stroke. 2021;23(1):146. DOI:10.5853/jos.2020.01004.e1
34. Singhal AB, Hajj-Ali RA, Topcuoglu MA, et al. Reversible cerebral vasoconstriction syndromes: analysis of 139 cases. Arch Neurol. 2011;68(8):1005-12. DOI:10.1001/archneurol.2011.68
35. Ducros A, Fiedler U, Porcher R, et al. Hemorrhagic manifestations of reversible cerebral vasoconstriction syndrome: frequency, features, and risk factors. Stroke. 2010;41(11):2505-11. DOI:10.1161/STROKEAHA.109.572313
36. Noguchi S, Miyaoka R, Miyachi H. Clinical Images: Symmetrical Gyriform Restricted Diffusion in Severe Reversible Cerebral Vasoconstriction Syndrome. World Neurosurg. 2023;177:86-7. DOI:10.1016/j.wneu.2023.06.042
37. Strunk D, Veltkamp R, Meuth SG, et al. Intra-arterial application of nimodipine in reversible cerebral vasoconstriction syndrome: a neuroradiological method to help differentiate from primary central nervous system vasculitis. Neurol Res Pract. 2022;4(1):8. DOI:10.1186/s42466-022-00173-0
38. Sequeiros JM, Roa JA, Sabotin RP, et al. Quantifying Intra-Arterial Verapamil Response as a Diagnostic Tool for Reversible Cerebral Vasoconstriction Syndrome. AJNR Am J Neuroradiol. 2020;41(10):1869-75.
39. Merli N, Padroni M, Azzini C, et al. Reversible cerebral vasoconstriction syndrome: strategies to early diagnosis and the role of transcranial color-coded doppler ultrasonography (TCCD). Neurol Sci. 2023;44(7):2541-5. DOI:10.1007/s10072-023-06755-3
40. Hathidara M, Patel NH, Flores A, et al. Transcranial Doppler findings in reversible cerebral vasoconstriction syndrome. J Neuroimaging. 2022;32(2):345-51. DOI:10.1111/jon.12946
41. Robba C, Taccone FS. How I use Transcranial Doppler. Crit Care. 2019 Dec 23;23(1):420. DOI:10.1186/s13054-019-2700-6
42. Sharma VK, Tsivgoulis G, Lao AY, et al. Noninvasive detection of diffuse intracranial disease. Stroke. 2007;38(12):3175-81.
43. Kulesh AA. Cerebral venous thrombosis and its hemorrhagic complications. Neurology, Neuropsychiatry, Psychosomatics. 2021;13(2):10-8 (in Russian).
44. Kulesh AA, Dyomin DA, Guseva AL, et al. Vestibular vertigo in emergency neurology. Russian neurological journal. 2021;26(4):50-9 (in Russian).
45. Edlow JA, Newman-Toker DE, Savitz SI. Diagnosis and initial management of cerebellar infarction. Lancet Neurol. 2008;7(10):951-64. DOI:10.1016/S1474-4422(08)70216-3
46. Barkhoudarian G, Kelly DF. Pituitary Apoplexy. Neurosurg Clin N Am. 2019;30(4):457-63. DOI:10.1016/j.nec.2019.06.001
47. Cho S, Lee MJ, Chung CS. Effect of Nimodipine Treatment on the Clinical Course of Reversible Cerebral Vasoconstriction Syndrome. Front Neurol. 2019;10:644. DOI:10.3389/fneur.2019.00644.
48. Avola G, Pezzini A. Treatment-Related Reversible Cerebral Vasoconstriction Syndrome. J Clin Med. 2024;13(19):5930. DOI:10.3390/jcm13195930.
49. Elstner M, Linn J, Müller-Schunk S, Straube A. Reversible cerebral vasoconstriction syndrome: a complicated clinical course treated with intra-arterial application of nimodipine. Cephalalgia. 2009;29(6):677-82. DOI:10.1111/j.1468-2982.2008.01768.x
50. Ospel JM, Wright CH, Jung R, et al. Intra-Arterial Verapamil Treatment in Oral Therapy-Refractory Reversible Cerebral Vasoconstriction Syndrome. AJNR Am J Neuroradiol. 2020;41(2):293-9. DOI:10.3174/ajnr.A6378.
51. Singhal AB, Topcuoglu MA. Glucocorticoid-associated worsening in reversible cerebral vasoconstriction syndrome. Neurology. 2017;88(3):228-36. DOI:10.1212/WNL.0000000000003510

Авторы

А.А. Кулеш*^1,2, Д.А. Демин³, Н.Л. Старикова¹, С.А. Мехряков^1,2, Н.А. Кайлева^1,2

¹ФГБОУ ВО «Пермский государственный медицинский университет им. акад. Е.А. Вагнера» Минздрава России, Пермь, Россия;
²ГАУЗ ПК «Городская клиническая больница №4», Пермь, Россия;
³ФГБУ «Федеральный центр сердечно-сосудистой хирургии» Минздрава России, Астрахань, Россия
*aleksey.kulesh@gmail.com

________________________________________________

Aleksey A. Kulesh*^1,2, Dmitry A. Demin³, Natalia L. Starikova¹, Sergey A. Mekhryakov^1,2, Nadezhda A. Kayleva^1,2

¹Vagner Perm State Medical University, Perm, Russia;
²City Clinical Hospital №4, Perm, Russia;
³Federal Center for Cardiovascular Surgery, Astrakhan, Russia
*aleksey.kulesh@gmail.com

Назад к списку

Цель портала OmniDoctor – предоставление профессиональной информации врачам, провизорам и фармацевтам.