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KMID : 0911820220230020027
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Korean Journal of Headache
2022 Volume.23 No. 2 p.27 ~ p.32
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Clinical Characteristics of Reversible Cerebral Vasoconstriction Syndrome: A Large Korean Multicenter Study
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Cho Soo-Hyun
Kim Byung-Kun
Lee Mi-Ji
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Abstract
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Background: Reversible cerebral vasoconstriction syndrome (RCVS) is an important cause of thunderclap headaches that can lead to neurological complications. We previously demonstrated the characteristics of RCVS in a single center in Korea. The present multicenter study investigated the clinical characteristics of RCVS in more large sample size of Korean patients.
Methods: In this multicenter study, patients with only angiogram-proven RCVS were enrolled. Angiogram-proven RCVS was defined when the multifocal vasoconstrictions were normalized within 3-6 months. We finally recruited 230 patients with angiogram-proven RCVS. Clinical features, etiologies, trigger factors, neurological manifestations and complications, and treatments were evaluated in included patients.
Results: Patients with RCVS were median 49 years (interquartile range, 38.0-60.0 years), with a female predominance (81.3%). In etiology, idiopathic RCVS (73.9%) was reported most frequently, followed by emotional stress (15.2%). Trigger factors of thunderclap headaches were reported in 187 (81.3%) patients in which, Valsalva maneuver (46.5%) was most common. During the follow-up period, neurological complication was reported in only 22 (9.5%) patients and modified Rankin score was 0 (98.7%) after three-month follow-up.
For the treatment of RCVS, nimodipine was used in almost all patients (96.1%).
Conclusion: Korean patients with RCVS appear to have idiopathic and benign RCVS. Compared to Western patients, lower prevalence of secondary etiology and neurological complications were observed. This may imply that clinical outcomes can be affected according to genetic, social and environmental factors in RCVS.
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KEYWORD
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Reversible cerebral vasoconstriction syndrome, idiopathic, Trigger factor, Neurological complication, Nimodipine
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