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Ann Neurol. 2016 Jun;79(6):882-94. doi: 10.1002/ana.24652. Epub 2016 Apr 28.

Reversible cerebral vasoconstriction syndromes and primary angiitis of the central nervous system: clinical, imaging, and angiographic comparison.

Author information

1
Massachusetts General Hospital and Harvard Medical School, Boston, MA.
2
Neurology Department, Hacettepe University Hospitals, Ankara, Turkey.
3
Department of Medicine, Yan Chai Hospital, Hong Kong, China.
4
Neurology Clinic, Ankara Numune Education and Research Hospital, Ankara, Turkey.
5
Grady Memorial Hospital and Emory University School of Medicine, Atlanta, GA.

Abstract

Reversible cerebral vasoconstriction syndromes (RCVS) and primary angiitis of the central nervous system (PACNS) are invariably considered in the differential diagnosis of new cerebral arteriopathies. However, prompt and accurate diagnosis remains challenging. Here we compared the features of 159 RCVS to 47 PACNS patients and developed criteria for prompt bedside diagnosis. Recurrent thunderclap headache (TCH), and single TCH combined with either normal neuroimaging, border zone infarcts, or vasogenic edema, have 100% positive predictive value for diagnosing RCVS or RCVS-spectrum disorders. In patients without TCH and positive angiography, neuroimaging can discriminate RCVS (no lesion) from PACNS (deep/brainstem infarcts). Ann Neurol 2016;79:882-894.

PMID:
27043703
DOI:
10.1002/ana.24652
[Indexed for MEDLINE]

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