Nimodipine-refractory reversible cerebral vasoconstriction syndrome treated effectively with verapamil
Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by recurrent thunderclap headache and reversible multifocal vasoconstrictions of the cerebral arteries. There are no treatment guidelines despite its potential for precarious outcomes. A 52-year-old woman with recurrent episodes o...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Sungkyunkwan University School of Medi
2020-12-01
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| Series: | Precision and Future Medicine |
| Subjects: | |
| Online Access: | http://www.pfmjournal.org/upload/pdf/pfm-2020-00198.pdf |
| _version_ | 1818657317031247872 |
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| author | So Young Park Joon Ho Lee In Ja Shin Raul G. Nogueira Jin Soo Lee |
| author_facet | So Young Park Joon Ho Lee In Ja Shin Raul G. Nogueira Jin Soo Lee |
| author_sort | So Young Park |
| collection | DOAJ |
| description | Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by recurrent thunderclap headache and reversible multifocal vasoconstrictions of the cerebral arteries. There are no treatment guidelines despite its potential for precarious outcomes. A 52-year-old woman with recurrent episodes of severe headache was diagnosed with RCVS and treated with oral nimodipine, which has been widely used for RCVS. However, her vessel status worsened despite treatment for several days and only improved after administration of intra-arterial (IA) and per os (PO) verapamil, which has been used to reverse vasoconstrictions in variant angina. Based on this case and literatures, we propose an alternative strategy using verapamil. The presence of a vascular reaction after an IA verapamil challenge during initial digital subtraction angiography can diagnose RCVS while also serving as an emergent treatment. Based on the response to IA verapamil, PO verapamil can be prescribed if there are no contraindications or side effects. |
| first_indexed | 2024-12-17T03:39:33Z |
| format | Article |
| id | doaj.art-de794006149642c39497299878875633 |
| institution | Directory Open Access Journal |
| issn | 2508-7940 2508-7959 |
| language | English |
| last_indexed | 2024-12-17T03:39:33Z |
| publishDate | 2020-12-01 |
| publisher | Sungkyunkwan University School of Medi |
| record_format | Article |
| series | Precision and Future Medicine |
| spelling | doaj.art-de794006149642c394972998788756332022-12-21T22:05:03ZengSungkyunkwan University School of MediPrecision and Future Medicine2508-79402508-79592020-12-014416116610.23838/pfm.2020.0019888Nimodipine-refractory reversible cerebral vasoconstriction syndrome treated effectively with verapamilSo Young Park0Joon Ho Lee1In Ja Shin2Raul G. Nogueira3Jin Soo Lee4 Department of Neurology, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea Department of Neurology, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea Department of Neurology, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea Department of Neurology and Radiology, Emory University, Atlanta, GA, USA Department of Neurology, Ajou University Hospital, Ajou University School of Medicine, Suwon, KoreaReversible cerebral vasoconstriction syndrome (RCVS) is characterized by recurrent thunderclap headache and reversible multifocal vasoconstrictions of the cerebral arteries. There are no treatment guidelines despite its potential for precarious outcomes. A 52-year-old woman with recurrent episodes of severe headache was diagnosed with RCVS and treated with oral nimodipine, which has been widely used for RCVS. However, her vessel status worsened despite treatment for several days and only improved after administration of intra-arterial (IA) and per os (PO) verapamil, which has been used to reverse vasoconstrictions in variant angina. Based on this case and literatures, we propose an alternative strategy using verapamil. The presence of a vascular reaction after an IA verapamil challenge during initial digital subtraction angiography can diagnose RCVS while also serving as an emergent treatment. Based on the response to IA verapamil, PO verapamil can be prescribed if there are no contraindications or side effects.http://www.pfmjournal.org/upload/pdf/pfm-2020-00198.pdfnimodipinereversible cerebral vasoconstriction syndromeverapamil |
| spellingShingle | So Young Park Joon Ho Lee In Ja Shin Raul G. Nogueira Jin Soo Lee Nimodipine-refractory reversible cerebral vasoconstriction syndrome treated effectively with verapamil Precision and Future Medicine nimodipine reversible cerebral vasoconstriction syndrome verapamil |
| title | Nimodipine-refractory reversible cerebral vasoconstriction syndrome treated effectively with verapamil |
| title_full | Nimodipine-refractory reversible cerebral vasoconstriction syndrome treated effectively with verapamil |
| title_fullStr | Nimodipine-refractory reversible cerebral vasoconstriction syndrome treated effectively with verapamil |
| title_full_unstemmed | Nimodipine-refractory reversible cerebral vasoconstriction syndrome treated effectively with verapamil |
| title_short | Nimodipine-refractory reversible cerebral vasoconstriction syndrome treated effectively with verapamil |
| title_sort | nimodipine refractory reversible cerebral vasoconstriction syndrome treated effectively with verapamil |
| topic | nimodipine reversible cerebral vasoconstriction syndrome verapamil |
| url | http://www.pfmjournal.org/upload/pdf/pfm-2020-00198.pdf |
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