Reversible cerebral vasoconstriction syndrome with posterior leucoencephalopathy after oral contraceptive pills
Soo, Y.; Singhal, A.B.; Leung, T.; Yu, S.; Mak, H.; Hao, Q.; Leung, H.; Lam, W.; Wong, L.K.S.
Cephalalgia An International Journal of Headache 30(1): 42-45
2010
ISSN/ISBN: 0333-1024 PMID: 20511194 DOI: 10.1111/j.1468-2982.2009.01868.xDocument Number: 210459
Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by sudden-onset recurrent 'thunderclap' headaches with reversible multifocal narrowing of the cerebral arteries, often associated with focal neurological deficits from ischaemic or haemorrhagic stroke. It has been associated with exposure to vasoconstrictive drugs, pregnancy, migraine, and a variety of other conditions. Whereas the pathophysiology of RCVS remains unclear, changes in the levels of female hormones are considered important because RCVS predominantly affects women and is frequently associated with pregnancy. We report a patient with angiographically confirmed RCVS whose MRI showed reversible brain oedema, suggesting an overlap between RCVS and the reversible posterior leucoencephalopathy syndrome. The only identified risk factor was oral contraceptive pills started 1 month prior to onset, supporting a role for female reproductive hormones in precipitating this overlap syndrome.
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