I. Cerebral aneurysm is defined as a cerebrovascular disorder causes of the blood vessel to bulge or balloon out of
the wall of a blood vessel as a result of the weaken of blood vessels and veins and occurred mostly at the bifurcations and branches of the large arteries located at the Circle of Willis.
II. Types of Cerebral aneurysm
A. Cerebral aneurysm classification based on angioarchitecture
Dr. Pritz MB. at the Indiana University School of Medicine, suggested that Only aneurysms in which preoperative imaging studies and operative findings were sufficient for classification
were included. All 329 reviewed aneurysms could be divided into 2
groups: fusiform (n=16) and saccular (n=313). Fusiform aneurysms could
be subdivided into 2 types: simple (no branch vessel; n=10) and complex
(one or more side branches; n=6). Saccular aneurysms could be subdivided
into 3 groups: those not associated with a branch vessel (n=31), those
associated with a side-branch vessel (n=125), and those located at a
bifurcation (n=157). Each of these categories of aneurysms could be
classified further based on its association with a conducting, primary,
secondary, tertiary, or side-branch vessel. Classification of cerebral
aneurysms according to this scheme adequately described all reviewed
aneurysms. Grouping aneurysms according to this approach focuses on
similarities in angioarchitecture and potential rheologic properties
that should prove useful for evaluation of aneurysm growth, rupture, and treatment(1).
B. Cerebral aneurysms classified both by size and shape
Others researchers suggested that Cerebral aneurysms are classified both by size and shape
B.1. In sizes
1. Diameter of less than 15 mm is classified into Small aneurysms
2. Large aneurysms with size from 15 to 25 mm
3. Giant aneurysms with size from 25 to 50 mm
4. Super giant aneurysms for any aneurysms with size over 50 mm.
B.2. In shapes
1. Berry or Saccular aneurysms
Saccular aneurysms are the most common form of cerebral aneurysm and refers to any aneurysm with a saccular outpouching, including berry aneurysms. Berry aneurysm, is a saccular aneurysm with a neck or stem resembling a berry.
2. Dissecting aneurysmsis is defined as a condition of splitting or dissection of an arterial wall as a result of bleeding into the weakened wall splits the wall.
3. Fusiform aneurysm is also known as Richet's aneurysma is a localized dilation of an artery in which the entire circumference of
the vessel is distended. The result is an elongated, tubular, or
spindlelike swelling(2).
III. Symptoms
People may have an aneurysm without experiencing any symptoms at all, but if a cerebral aneurysm begins to leak it can cause certain symptoms. Dr. Lyrer P, and Gratzl O. at the Neurologische Universitätsklinik, indicated that approximately two fifth of the patients with subarachnoidal hemorrhage complained of early symptoms prior to the major hemorrhage. The complaints may be
1. Headache as the most likely
2. Cranial nerve palsies including the muscles of the face, and people's faces change as a result of the palsy. A patient may find it difficult to smile, to control eye movements, and to engage in other facial expressions.
3. Different vegetative symptoms, including the interference of the following, including thought, emotion, memory, comprehension, perception, purpose, etc.
4. Iransient neurologic deficits, etc.(3)
In the report of Dr. Henry J. Kaminski, M.D and the team at Cleveland Veterans Affairs Medical Center showed that transient neurologic deficits are an unusual presentation of chronic
subdural hematoma. Presented herein are three patients with transient
aphasia and right-sided sensory-motor abnormalities caused by subdural
hematoma. Review of the literature revealed 32 cases similar to ours.
Presenting complaints were aphasia (77%), sensory symptoms (57%),
headache (48%), hemiparesis (50%), and visual disturbance (3%). Fifteen
patients underwent cerebral angiography(4)
IV. Cause and Risk factors
A. Causes
Cerebral aneurysms develop as a result of the weaken of blood vessels and veins of which exhibit the risk of ruptured cerebral aneurysm. Aneurysms often occur mostly at the bifurcations and branches of the large arteries located at the Circle of Willis based of the brain.
B. Risk factors
1. Hypertension (significant risk factor for future SAH)
In the study to reveal and assess risk factors
for intraoperative rupture (IOA) of aneurysms, which will reduce the
incidence of this complication and improve the outcome of treatment, Dr.Taylor CL, and the research team at Case Western Reserve University indicated that for patients with an unruptured cerebral aneurysm as the primary diagnosis, hypertension was found to be a significant risk factor for future SAH (risk ratio: 1.46, 95% confidence interval (CI): 1.01-2.11), whereas surgical treatment (risk
ratio: 0.29, 95% CI: 0.09-0.97) had a significant protective effect.
Advancing age had a small but significant protective effect in both
groups. Elderly patients identified with unruptured aneurysms are more
likely to have coexisting hypertension than the general hospitalized
population. In elderly patients hospitalized with an unruptured cerebral aneurysm as their primary diagnosis, hypertension is a risk factor for subsequent SAH, whereas surgical treatment is a protective factor against SAH(5).
2. Family history
In the study of the incidence of asymptomatic, unruptured cerebral aneurysms among patients with a family history of SAH within the second degree of consanguinity. Forty-one unruptured cerebral aneurysms
were found in 34 (13.9%) of 244 patients. This incidence was
significantly higher than that found in a control group of healthy
volunteers (6%). Furthermore, patients who had a family history of SAH combined with multiple systemic risk factors were found to have the highest incidence of unruptured aneurysms (32%; odds ratio 3.49, 95% confidence interval 1.37-8.9)(6).
3. Old Age and gender
a. Old age is considered as one of risk factor of Cerebral aneurysm. In the study of the complication of Three hundred fifty-five patients underwent 394 endovascular procedures treating 75 aneurysm recurrences and 319 untreated aneurysms. One hundred eight (30%) were elderly(7)
b. Women are at increased risk of Cerebral aneurysm than men,
4. Smoking
In the study to investigate whether cigarette smoking increased the risk of developing cerebral aneurysms and of SAH. Degree of smoking was investigated in 182 patients with SAH and in 123 patients with an unruptured cerebral aneurysm incidentally detected during investigation of other diseases, showed that Smoking significantly increased the risk of both aneurysm formation and SAH; The odds ratio for SAH was 2.4, and for unruptured cerebral aneurysm 1.7. Smoking especially increased the occurrence of SAH in women and in youngsters. However, smoking did not influence the occurrence of cerebral vasospasm and multiplicity of aneurysms(8).
5. Arteriosclerosis
Disruption of the entire arterial wall may be a critical event in the
development of IDA and result in the medial disruption and
subadventitial haemorrhage. Non-atheromatous intima might function as a
protective factor in arterial wall disruption. On the other hand,
atherosclerosis may predispose to intra-atheromatous plaque haemorrhage
type of IDA through intramural haemorrhage originating from the newly
formed vessels(9).
6. Drug abuse
Dr. Vannemreddy P, and the team at the Louisiana State University Health Sciences Center suggested that Aneurysms were significantly smaller and ruptured at a younger age among cocaine
users compared with nonusers. Although the poor clinical grade was not
significantly different between the 2 groups, outcome was significantly
worse in cocaine users(10).
7. Head injury
There are a report of three cases of ruptured traumatic aneurysms of the peripheral anterior cerebral artery after closed head injury. These cases were all young men with closed head injury due to traffic accidents(11).
8. Heavy alcohol consumption
"Heavy drinking
impairs outcome mainly through severe rebleeding and delayed ischaemia
and to a lesser extent through a poor initial condition and presence of
intracerebral haematoma
". Dr. Juvela S. at the Helsinki University Hospital said(12).
9. Certain blood infections
Certain blood infections may increased the risk of Cerebral aneurysm, including Streptococcus sanguinis(13), endocarditis(14), Etc.
10. Lower estrogen levels after menopause
Researchers at the Affiliated ZhongShan Hospital, DaLian University, in the study of The role of estrogen in the formation of experimental abdominal aortic aneurysm, showed that in the pathogenesis of abdominal aortic aneurysm (AAA), estrogen may play an inhibitory role by decreasing expression of MMP-2 and MMP-9 synthesis(15).
11. Risk factors present at birth
a. Ehlers-Danlos syndrome type IV is defined as a condition characterized by its clinical manifestations, which
are easy bruising, thin skin with visible veins, and rupture of
arteries, uterus, etc. There is a report of report a case presented with cervical radiculopathy due to a segmental fusiform aneurysm of the cervical vertebral artery(16).
b. Polycystic kidney disease
Autosomal dominant polycystic kidney disease(ADPKD) is primarily associated with renal failure, but it also causes systemic diseases, including cysts of other systemic organs and cerebral or visceral aneurysm(17). Other suggested that Polycystic kidney disease has been associated with several aneurysms, most notably cerebral,
but not popliteal. The patient's marfanoid habitus also may have played
a part. This case emphasises the mixed aetiology of popliteal
aneurysms(18).
c. Abnormally narrow aorta (coarctation of the aorta), the large blood vessel that delivers oxygen-rich blood from the heart to the body. There is a report of the frequency of IA among patients with CoA is approximately 5-fold that
of the general population. Although no risk factors were identified in
this cohort, additional prospective evaluation is warranted. These data
suggest that noninvasive cerebral imaging to screen for IA should be
considered in patients with CoA(19).
d. Cerebral arteriovenous malformation (brain AVM),
There are reports of 2 cases of subarachnoid hemorrhage associated with neurofibromatosis
type I (von Recklinghausen's disease) are reported. A 30-year-old male
patient (case 1) had been diagnosed as having neurofibromatosis type I
due to neurofibroma and café-au-lait spot. He suffered from subarachnoid
hemorrhage and angiography showed multiple aneurysms in the right and left middle cerebral arteries and left internal carotid artery. He also had arteriovenous malformation in the left temporal lobe(20).
e. Etc.
V. Complications and diseases associated with Cerebral aneurysm
A. Complications
Complications during cerebral aneurysm
embolization continue to occur even at high volume experienced centers.
Such situations are unexpected, complex and can have devastating
consequences(21). Others indicated that Systemic complications secondary to subarachnoid hemorrhage from an aneurysm
are common (40%) and the mortality attributable to them (23%) is
comparable to mortality from the primary lesion, rebleeding, or
vasospasm(22). Dr. Chen M. suggested that the two most serious neuroendovascular procedural complications-namely, aneurysm perforation and thromboemboli aims to propose a role based checklist(23). Other complications include
1. Re-bleeding
there is a report of fifty-three of 236 consecutive patients (22.5%) who suffered a proved
aneurysmal subarachnoid hemorrhage and who were admitted within 72 hours
after subarachnoid hemorrhage to a primary emergency hospital had at
least one rebleed within 6 months after the primary bleed. Two patients
later had a rebleed within a mean of 3 years follow-up. Rebleeding was
recorded if there was a sudden loss of consciousness and a verification
by computed tomography, autopsy, lumbar puncture, or angiography. The
peak incidence of rebleeding was within the first 24 hours and at the
end of the first week after subarachnoid hemorrhage. The rebleed
mortality rate was 74%, and only 19% of patients with a rebleed had a
good outcome. The grade on admission, age, and sex do not affect the
incidence nor the time of rebleeding(24).
2. Vasospasm.
In the continuation of a review of delayed vasospasm after aneurysmal subarachnoid haemorrhage, originally published in 1994 and partially updated at the ninth vasospasm conference in Turkey. The incidence of delayed ischaemic deficit (DID) or symptomatic vasospasm
reported in 1994 was 32.5% in over 30,000 reported cases. In recent
years, 1994-2009, it was 6,775/23,806, or 28.5%. Many of the recent
reports did not specify whether a calcium antagonist was used routinely,
and when this was stated (usually nimodipine or nicardipine), DID was
noted in 22.0% of 10,739 reported patients. The outcome of delayed
ischaemia in the earlier survey was a death rate of 31.6%, with
favourable outcomes in 36.2%. In recent reports, though with fewer than
1,000 patients, the outcome is possibly better, with death in 25.6% and
good outcome in 54.1%. It thus appears likely that delayed vasospasm is still common but less so, and that the overall outcome has improved(25).
3. Hydrocephalus
Dr. Harrigan MR and the team at University of Alabama at Birmingham indicated that Patients underwent treatment of the ruptured aneurysm
an average of 47.4 hours after admission and received an average total
dose of 40.6 g of EACA. The mean length of time of administration of
EACA was 35.6 hours. There was a total of 5 rehemorrhages, for an
overall rebleeding rate of 1.4% and a rate of rehemorrhage per 24-hour
period of 0.71%. Overall, the rates of symptomatic vasospasm and
permanent neurological deficits attributable to ischemic stroke were
11.5% and 7.2%, respectively, and the incidence of shunt-dependent hydrocephalus
was 42.3%. Patients who were treated with coiling had higher rates of
symptomatic vasospasm and ischemic complications than patients who had
surgery(26).
4. Hyponatremia
Hyponatremia
following subarachnoid hemorrhage (SAH) therefore appears to be the result of increased
natriuresis, due to the inappropriate elevation of ANP rather than
SIADH. In this situation, water restriction should not be recommended,
since the circulatory volume is decreased(27).
5. Etc.
B. Diseases associated with Cerebral aneurysm
1. Von Recklinghausen's neurofibromatosis
Dr. J Baldauf and the research team at the Department of Neurosurgery, Helios Hospital Berlin report a case of an intracranial aneurysm associated with
von Recklinghausen's neurofibromatosis. A 34-year-old woman presented
with a history of headaches, unconsciousness and neck rigidity.
Widespread cutaneous neurofibromas were found. Investigations revealed
an aneurysm of the anterior communicating artery(28)
2. Behçet's disease
Although Cerebral aneurysms in Behçet's disease are very rare. Dr. S Nakasu and the research indicated there is a case of a 57 year old man with Behçet's disease is described, who had a
subarachnoid hemorrhage due to rupture of a peripheral
middle cerebral artery aneurysm. He
underwent a successful aneurysmal clipping. Three years later he had
seizures and was
found to have a new aneurysm on the
contralateral peripheral middle cerebral artery as well as some
radiological features
of vasculitis. After 3 months of
steroid therapy, the aneurysm disappeared. Although surgical treatment
is the first choice
for ruptured aneurysms, steroid therapy
may be effective for unruptured small aneurysms in patients with
Behçet's disease(29).
3. Marfan syndrome
Marfan syndrome
is an autosomal dominant connective tissue disorder commonly due to
mutation of the fibrillin-1 (FBN-1) gene that causes disruption of
elastic fibers in large- and medium-size arteries and predisposes to aneurysm formation and arterial dissection. Cardiovascular complications occur in most patients with Marfan syndrome, but interestingly, neurovascular complications of Marfan syndrome are rare(30).
4. Pseudoxanthoma elasticum
Although intracranial aneurysms have been associated with many
hereditary collagen disorders, the incidence of brain aneurysms in pseudoxanthoma elasticum
(PXE) appears to be exceedingly low and uncertain. There is a rare
case of a sisters with PXE who both developed intracranial aneurysms.
This report supports the previously questioned hypothetical association
between PXE and intracranial aneurysms(31).
5. Ehlers-Danlos syndrome
Ehlers-Danlos syndrome
Type IV is a heritable connective tissue disorder with frequent
neurovascular manifestations, such as intracranial aneurysms. Patients
with this syndrome
have notoriously fragile blood vessels, and the reported mortality rate
for any type of vascular surgical procedure is 40%. This syndrome is rare, however, and the complication rate of aneurysm surgery may have been overestimated(32)
6. Hypoplasia and fibromuscular dysplasia
Fibromuscular dysplasia
represents one of the more common types of arterial fibrodysplasia, a
heterogeneous group of nonatherosclerotic vascular occlusive and
aneurysmal diseases. There is a report of the first case, to the knowledge, of an elderly man with infrarenal aortic fibromuscular dysplasia associated with aortic hypoplasia, without involvement of renal arteries, and contiguous aortoiliac aneurysm(33).
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(1) http://www.ncbi.nlm.nih.gov/pubmed/20621522
(2) http://medical-dictionary.thefreedictionary.com/fusiform+aneurysm
(3) http://www.ncbi.nlm.nih.gov/pubmed/8419992
(4) http://www.sciencedirect.com/science/article/pii/000293439290790I
(5) http://www.ncbi.nlm.nih.gov/pubmed/7472548
(6) http://www.ncbi.nlm.nih.gov/pubmed/10470812
(7) http://www.ncbi.nlm.nih.gov/pubmed/22241386
(8) http://www.ncbi.nlm.nih.gov/pubmed/10478344
(9) http://www.ncbi.nlm.nih.gov/pubmed/11318898
(10) http://www.ncbi.nlm.nih.gov/pubmed/18312093
(11) http://www.ncbi.nlm.nih.gov/pubmed/9125717
(12) http://www.ncbi.nlm.nih.gov/pubmed/1633519
(13) http://www.ncbi.nlm.nih.gov/pubmed/22385612
(14) http://www.ncbi.nlm.nih.gov/pubmed/7477721
(15) http://www.ncbi.nlm.nih.gov/pubmed/18585678
(16) http://www.ncbi.nlm.nih.gov/pubmed/21430980
(17) http://www.ncbi.nlm.nih.gov/pubmed/22293308
(18) http://www.ncbi.nlm.nih.gov/pubmed/12954963
(19) http://www.ncbi.nlm.nih.gov/pubmed/14661678
(20) http://www.ncbi.nlm.nih.gov/pubmed/9513196
(21) http://www.ncbi.nlm.nih.gov/pubmed/22053099
(22) http://www.ncbi.nlm.nih.gov/pubmed/21298910
(23) http://www.ncbi.nlm.nih.gov/pubmed/22053099
(24) http://www.sciencedirect.com/science/article/pii/009030198990133X
(25) http://www.ncbi.nlm.nih.gov/pubmed/21116906
(26) http://www.ncbi.nlm.nih.gov/pubmed/20881558
(27) http://www.ncbi.nlm.nih.gov/pubmed/8874554
(28) http://www.neurologyindia.com/article.asp?issn=0028-3886;year=2005;volume=53;issue=2;spage=213;epage=215;aulast=Baldauf
(29) http://jnnp.bmj.com/content/70/5/682.full
(30) http://www.ncbi.nlm.nih.gov/pubmed/21723458
(31) http://www.ncbi.nlm.nih.gov/pubmed/21423077
(32) http://www.ncbi.nlm.nih.gov/pubmed/12188938
(33) http://www.ncbi.nlm.nih.gov/pubmed/19118740
(34) http://www.ncbi.nlm.nih.gov/pubmed/18641840
(35) http://www.ncbi.nlm.nih.gov/pubmed/22522330
(36) http://www.ncbi.nlm.nih.gov/pubmed/22279477
(37) http://www.ncbi.nlm.nih.gov/pubmed/18951749
(38) http://www.ncbi.nlm.nih.gov/pubmed/1882713
(39) http://www.ncbi.nlm.nih.gov/pubmed/22569997
(40) http://www.ncbi.nlm.nih.gov/pubmed/21509633
(41) http://www.ncbi.nlm.nih.gov/pubmed/18312093
(42) http://www.ncbi.nlm.nih.gov/pubmed/22011856
(43) http://www.ncbi.nlm.nih.gov/pubmed/21952693
(44) http://www.ncbi.nlm.nih.gov/pubmed/16418439
(45) http://www.bioscirep.org/bsr/017/0085/0170085.pdf
(46) http://www.ncbi.nlm.nih.gov/pubmed/9027584
(47) http://www.ncbi.nlm.nih.gov/pubmed/17023716
(48) http://www.ncbi.nlm.nih.gov/pubmed/10488389
(49) http://www.ncbi.nlm.nih.gov/pubmed/15833383
(50) http://www.ncbi.nlm.nih.gov/pubmed/20706936
(51) http://www.ncbi.nlm.nih.gov/pubmed/20178390
(52) http://www.ncbi.nlm.nih.gov/pubmed/20218618
(53) http://mi.rsmjournals.com/content/17/1/19.abstract
(54) http://www.ncbi.nlm.nih.gov/pubmed/21967159
(55) http://www.ncbi.nlm.nih.gov/pubmed/21458299
(56) http://www.ncbi.nlm.nih.gov/pubmed/18938206
(57) http://www.ncbi.nlm.nih.gov/pubmed/14995053
(58) http://www.ncbi.nlm.nih.gov/pubmed/9543108
(59) http://www.ncbi.nlm.nih.gov/pubmed/18466729
(60) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2835915/
(61) http://www.ncbi.nlm.nih.gov/pubmed/10632092
(62) http://www.ncbi.nlm.nih.gov/pubmed/20514403
(63) http://www.ncbi.nlm.nih.gov/pubmed/18296359
(64) http://www.ncbi.nlm.nih.gov/pubmed/22027055
(65) http://www.ncbi.nlm.nih.gov/pubmed/22269864
(66) http://www.ncbi.nlm.nih.gov/pubmed/12499631
(67) http://pubs.acs.org/doi/abs/10.1021/jf035354z
(68) http://www.ncbi.nlm.nih.gov/pubmed/11726811
(69) http://www.ncbi.nlm.nih.gov/pubmed/20420369
(70) http://www.ncbi.nlm.nih.gov/pubmed/17923995
(71) http://www.ncbi.nlm.nih.gov/pubmed/17562569
(72) http://www.ncbi.nlm.nih.gov/pubmed/21375325
(73) http://www.ncbi.nlm.nih.gov/pubmed/12710715
(74) http://www.ncbi.nlm.nih.gov/pubmed/19932588
(75) http://www.ncbi.nlm.nih.gov/pubmed/20136443
(76) http://www.ncbi.nlm.nih.gov/pubmed/19631195
(77) http://www.ncbi.nlm.nih.gov/pubmed/21861721
(78) http://www.ncbi.nlm.nih.gov/pubmed/19697921
(79) http://www.ncbi.nlm.nih.gov/pubmed/19411814
(80) http://www.ncbi.nlm.nih.gov/pubmed/2728763
(81) http://www.ncbi.nlm.nih.gov/pubmed/6738404
(82) http://www.ncbi.nlm.nih.gov/pubmed/22585565
(83) http://www.ncbi.nlm.nih.gov/pubmed/12557811
(84) http://www.ncbi.nlm.nih.gov/pubmed/16562825
(85) http://www.ncbi.nlm.nih.gov/pubmed/19703353
(86) http://www.ncbi.nlm.nih.gov/pubmed/20371279
(87) http://www.ncbi.nlm.nih.gov/pubmed/22070681
(88) http://www.ncbi.nlm.nih.gov/pubmed/21864416
(89) http://www.ncbi.nlm.nih.gov/pubmed/17597507
(90) http://www.ncbi.nlm.nih.gov/pubmed/16762125
(91) http://www.ncbi.nlm.nih.gov/pubmed/19053860
(92) http://www.ncbi.nlm.nih.gov/pubmed/15844828
(93) http://www.ncbi.nlm.nih.gov/pubmed/20567593
(94) http://www.ncbi.nlm.nih.gov/pubmed/11207456
(95) http://www.ncbi.nlm.nih.gov/pubmed/22135905
(96) http://www.ncbi.nlm.nih.gov/pubmed/19918711
(97) http://www.ncbi.nlm.nih.gov/pubmed/19497358
(98) http://www.ncbi.nlm.nih.gov/pubmed/16759447
(99) http://www.ncbi.nlm.nih.gov/pubmed/21764282
(100) http://www.ncbi.nlm.nih.gov/pubmed/21056842
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Friday, April 6, 2012
Reversible cerebral vasoconstriction syndrome - Headache/Stroke
I. Stroke is a result of a blockage in the blood vessels (ischemic stroke)
or bleeding (hemorrhagic stroke) of that associated ischemic stroke,
transient ischemic attack, or non-traumatic intracranial hemorrhage,
including intracerebral and subarachnoid hemorrhage, etc. according to "Headache attributed to stroke, TIA, intracerebral haemorrhage, or vascular malformation" by Carolei A, Sacco S.(1)
II. A headache or cephalalgia is defined as a condition of pain in the region around the head or neck. Normally, it is a symptom of a number of different effects of certain diseases or the head and neck themselves. High headache impact was proven to be associated with worse academic performance.
III. Reversible cerebral vasoconstriction syndrome (RCVS)
Reversible cerebral vasoconstriction syndrome, sometimes called Call-Fleming syndrome is defined as a condition of disease of the arteries of which the brain develops a blood vessels spasm that leads to multifocal arterial constriction and dilation, causing the sudden onset of a severe headache (2)
1. Does stroke causes headache?
A sudden severe headache or recurrent of thunderclap headache may be a beginning of a stroke as a result of a hemorrhagic stroke.
2. Does headache causes stroke?
Cerebral vasoconstriction due to severe headache may cause completely stop blood flow to a portion of the brain, causing stroke if the blood vessel can not relax fast for blood to flow again(2)
II. Symptoms
1. Sudden-onset thunderclap headache or recurrent severe headache
2. Dysarthria
Dysarthria is defined as a condition of motor speech disorder resulting from neurological injury of the motor component of the motor-speech system due to the can spontaneously constriction of and relax back and forth over a period of time of cerebral arteries.
3. Nausea, Vomiting, Photophobia, Confusion and Blurred vision(3)
4. Unsteady movement of the limbs
5. Overactive or overresponsive reflexes
As a result of upper motor neuron damage causes of focal neurological symptoms.
6. Etc.
V. Causes and risk factors
Some researchers suggested reversible cerebral vasoconstriction syndrome (RCVS) may be a results from a transient disturbance of the circle of arteries that supply blood to the brain of which leads to its constriction.
1. Antidepressants
Antidepressants used to treat depression, anxiety disorders, and some personality disorders may increase risk of diffuse cerebral vasoconstriction(5)
2. Nasal decongestants
In the investigation conducted by Lariboisière Hospital of clinical, neuroimaging and outcome data of 67 consecutive patients prospectively diagnosed over 3 years in our institution with an angiographically confirmed RCVS, 43 females and 24 males with a mean age of 42 years (19-70). RCVS was spontaneous in 37% of patients and secondary in the 63% others, to postpartum in 5 and to exposure to various vasoactive substances in 37, mainly cannabis, selective serotonin-recapture inhibitors and nasal decongestants(6)
3. Eletriptan
A pediatric case of reversible cerebral vasoconstriction syndrome with cortical subarachnoid hemorrhage, suggested that Eletriptan might cause vasoconstriction of cerebral arteries. Although most patients with RCVS are adults and pediatric cases are rare, RCVS should be considered in a child complaining of severe headache(7)
4. Vasoconstrictive drug exposure and migraine
In the study of clinical, laboratory, and imaging features of patients with reversible cerebral vasoconstriction syndromes evaluated at 2 academic centers, compare subgroups, conducted by
6. Evoked by pregnancy(4)
7. Exposure to vasoactive substances such as angiotensin II, epinephrine, norepinephrine, vasopressin can lead to constrictor dilate of blood vessels)(4)
8. Etc.
VI. Diagnosis
A. Misdiagnosis
Reversible cerebral vasoconstriction syndrome (RCVS) constitutes an under-recognised but clinically important diagnosis, because it can be complicated by a cerebrovascular accident. The syndrome is often misdiagnosed as it resembles. Misdiagnosis of Reversible Cerebral Vasoconstriction Syndromes as primary cerebral vasculitis and aneurysmal subarachnoid hemorrhage is common because of overlapping clinical and angiographic features, researchers at Cleveland Clinic Lerner College of Medicine of Case Western Reserve University and Cleveland Clinic Foundation, said, as reversible cerebral vasoconstriction syndromes (RCVS) comprise a group of diverse conditions, all characterized by reversible multifocal narrowing of the cerebral arteries heralded by sudden (thunderclap), severe headaches with or without associated neurologic deficits(11). Other study reported demonstration of two female patients presented with severe headache with subsequent angiographic findings of ‘bead and string’ appearances of the cerebral arteries at Circle of Willis, which resolved spontaneously within 3 months. Diagnosis of reversible cerebral vasoconstriction syndrome was made. The clinical and imaging characteristics in different modalities are discussed(10)
1. Primary Angiitis of the Central Nervous System
Primary angiitis of the central nervous system is defined as an idiopathic disorder characterized by vasculitis within the dural confines. Headache and encephalopathy are the most frequent initial symptoms. Stroke or focal symptoms develop in less than 20% of patients at the onset of disease and are uncommon in the absence of headache or encephalopathy. Symptoms or signs of vasculitis outside of the central nervous system are rare; serologic markers of inflammation are typically normal(16). A Medline search was performed to identify all case reports since 1966 describing RCVS and PACNS that provide sufficient clinical detail to permit diagnostic classification according to published criteria. RCVS included case studies in which there was angiographic or transcranial Doppler ultrasound evidence of near-to-complete resolution of cerebral vasoconstriction in the absence of a well-recognized secondary cause. PACNS included reports of histologically confirmed PACNS either through biopsy or necropsy(17)
2. Post-partum cervicocephalic artery dissection (pp-CAD)
In a report of a 41-year-old right-handed African-American woman who developed the syndrome of pp-CAD (headaches, trace subarachnoid hemorrhage and diffuse cerebral arteriopathy on angiogram), researchers at the Northwestern University, hypothesized whether transient arterial wall abnormalities, postpartum hormonal changes or subtle connective tissue aberrations play a similar role in the pathogenesis of these two associated Post-partum cervicocephalic artery dissection (pp-CAD) and Reversible cerebral segmental vasoconstriction (RCSV)(16)
3. Subarachnoid Haemorrhage
Subarachnoid hemorrhage is defined as a bleeding in the subarachnoid space area between the brain and the thin tissues that cover the brain, causing certain similar symptoms to those of Reversible cerebral vasoconstriction syndrome. In the report of the case of a 51-year-old woman who presented to hospital following a thunderclap headache, initially thought to be secondary to a subarachnoid haemorrhage (SAH). A tiny anterior choroidal artery aneurysm was demonstrated on cerebral angiogram. At surgical clipping, no evidence of haemorrhage was observed. Post-operatively, the patient developed delayed right-sided hemiparesis, managed with aggressive hypertensive treatment, and later, with onset of septicaemia, central visual loss. Computed tomography (CT) brain scans demonstrated oedematous changes within the parieto-occipital regions bilaterally and later areas of infarction. The initial diagnosis of SAH was revised to reversible cerebral vasoconstriction syndrome (RCVS), which gave rise to Posterior reversible encephalopathy syndrome (PRES)(18). Another report on a pediatric case of RCVS with cortical subarachnoid hemorrhage (SAH). A 12-year-old boy developed acute, severe headache with paralysis of lower extremities causing gait disturbance after administration of eletriptan. Brain magnetic resonance angiography (MRA) revealed multifocal narrowing of the cerebral arteries, whereas magnetic resonance imaging (MRI) demonstrated sulcal hyperintensity on fluid-attenuated inversion recovery, consistent with cortical SAH. The patient's clinical symptoms resolved spontaneously after a few days and the MRI and MRA findings disappeared 3months later, suggesting a diagnosis of RCVS. Eletriptan might cause vasoconstriction of cerebral arteries. Although most patients with RCVS are adults and pediatric cases are rare, RCVS should be considered in a child complaining of severe headache.(19)
4. Orgasmic headache
Orgasmic headache (OH) is a condition of an "explosive" headache that occurs at orgasm. In a report of 34-year-old woman who presented with isolated and recurrent TCH at orgasm, which fulfilled the diagnosis of OH. However, she was post-partum and had recent exposure to ecstasy, making her symptoms highly suggestive of RCVS. Brain magnetic resonance angiography showed segmental vasoconstriction(15)
5. Etc.
B. Diagnosis
1. Catheter angiogram
Catheter angiogram, is the use of a thin plastic tube, called a catheter, is inserted into a large artery and threaded through the circulatory system to the carotid artery, through a small incision in the skin, together with X-rays and a contrast dye in visualizing the blood vessels of the brain. Then a series of radiographs is taken as the contrast agent spreads through the brain's arterial system, then a second series as it reaches the venous system.
2. CT scan
CT scan can dive your doctor a three-dimensional view of your blood vessels of the brain to look for masses and other abnormalities that cause Reversible cerebral vasoconstriction syndrome
3. Magnetic resonance imaging (MRI)
By using radio waves and magnetic fields to take pictures, MRI scan provides very high quality of a cross-sectional slice and lengthwise slices of the brain and thus providing the better and detail image of location of tumor and the surrounding structures. It is one of most likely early test ordered by a doctor to diagnose tumors, strokes, aneurysms, neurological diseases and other brain abnormalities and the blood vessels around the brain.
4. Computed tomography angiography (CTA)
CTA is a test to create detailed images of the blood vessels of the brain to look for neurological diseases and any abnormality with the use of the combination of the technology of a conventional CT scan with that of traditional angiography.
5. Cerebral magnetic resonance angiography (MRA)
Magnetic resonance angiography (MRA) is an accurate non-invasive tool for imaging the cerebral vessels. It provides morphologic information about the cerebral vessels relying on blood flow as the physical basis for generating contrast between stationary tissues and moving spins. 'Selective' MRA gives functional information about the cerebrovascular system such as flow direction, origin of flow, and presence or absence of collaterals. Arteries and veins can be imaged selectively due to their usually opposite flow directions. Although at a relatively early stage of development, MRA has already become a widely used tool for the study of the cerebrovascular system(12)
In the study of One hundred five (79%) of all 133 aneurysms detected with MRA by a neuroradiologist, 100 (75%) detected by an experienced neurosurgeon, 84 (63%) detected by a general radiologist, and 80 (60%) detected by a resident neuroradiologist, conducted by Nagatomi Neurosurgical Hospital, found that although MRA is useful in the diagnosis of cerebral aneurysms, sufficient experience and careful attention are necessary for accurate diagnosis of aneurysms located at the internal carotid and anterior cerebral arteries(13)
6. Etc.
VIII. Treatments
1. Calcium channel inhibitors (nimodipine, nifedipine or verapamil)
a. In the observation of a 63-year-old female with developed visual field impairment and a right-sided hemiparesis. Brain MRI revealed bilateral posterior and left parietal ischaemic strokes and Cerebral catheter angiography showed segmental arterial vasoconstriction, after 11 days onset of headache, a vasodilative therapy with calcium channel inhibitors was started and serial transcranial Doppler ultrasonography demonstrated resolution of cerebral arterial vasoconstriction(14)
b. Side effects are not limit to
b.1. Constipation
b.2. Nausea,
b.3 Headache
b.4. Rash,
b.5. Edema
b.6. Low blood pressure
b.7. Drowsiness, and dizziness
b.8. Etc.
2. Corticosteroids
a. Corticosteroids (commonly called steroids) are synthetic medicine closely resemble cortisol, a hormone produced adrenal glands produce naturally. In the report of a severe case of a 53-year-old woman with RCVS having an unruptured cerebral aneurysm and presenting as cortical subarachnoid hemorrhage, reversible posterior leukoencephalopathy syndrome, and cerebral infarction, by Juntendo University Shizuoka Hospital showed that the patient was successfully treated with corticosteroids and a calcium channel blocker and the aneurysm was clipped. Her various complications are due to the responsible vasoconstriction that started distally and progressed towards proximal arteries. This case demonstrates the spectrum of presentations of RCVS, a clinically complicated condition(20)
b. Side effects are not limit to
b.1. Bones thinning,
b.2. Avascular necrosis of bones
b.3. Swelling of the face
b.4. The medicine can inhibit natural hormones
b.5. It may cause liver damage
b.6. It may lower HDL cholesterol, and raise LDL cholesterol
b.7. Etc.
3. Intravenous magnesium sulfate
a. Magnesium sulfateis is a chemical compound with the formula MgSO4. In the report of four postpartum women aged 15 to 33 years developed acute neurologic deficits 1 to 8 days after uncomplicated deliveries. One had a history of migraine headaches and 2 had histories of spontaneous abortion. Two of the patients had uneventful pregnancies and 2 had preeclampsia, 1 of whom had acute hepatic failure, conducted by Jennifer E and the team showed that aggressive treatment was attempted with most patients including intravenous magnesium sulfate, corticosteroids, calcium channel blockers, balloon angioplasty, vasopressors, and osmotic agents. Two patients underwent serial angiography, with results showing severe, recurrent proximal vasoconstriction involving all major intracranial vessels.
b. Side Effects are not limit to
b.1. It may cause severe allergic reactions, including rash; hives; itching; difficulty breathing; tightness in the chest swelling of the mouth, face, lips, or tongue.
b.2. Dizziness
b.3. Flushing;
b.4. Irregular heartbeat
b.5. Sweating
b.6. Etc.
4. Etc.
Natural Remedies for Dementia Memory Loss Reversal
Guarantee to Stop Progression and Reverse Memory Loss in Alzheimer and Dementia with step by step instructions through Scientific Studies within 2 Months or your Money back
Super foods Library, Eat Yourself Healthy With The Best of the Best Nature Has to Offer
For over 100 healthy recipes, http://diseases-researches.blogspot.ca/p/blog-page_17.html
Sources
(1) http://www.ncbi.nlm.nih.gov/pubmed/20816453
(2) http://www.ncbi.nlm.nih.gov/pubmed/19220301
(3) http://www.ncbi.nlm.nih.gov/pubmed/20936928
(4) http://www.ncbi.nlm.nih.gov/pubmed/21179608
(5) http://www.ncbi.nlm.nih.gov/pubmed/16832100
(6) http://www.ncbi.nlm.nih.gov/pubmed/18025032
(7) http://www.sciencedirect.com/science/article/pii/S038776041200006X
(8) http://www.medscape.org/viewarticle/748234_3
(9) http://www.ncbi.nlm.nih.gov/pubmed/22000400
(10) http://www.hkcr.org/publ/Journal/vol13no3/full/149-53%20Imaging.pdf
(11) http://www.ncbi.nlm.nih.gov/pubmed?term=Narrative%20Review%3A%20Reversible%20Cerebral%20Vasoconstriction%20Syndromes
(12) http://www.biomedsearch.com/nih/Cerebral-magnetic-resonance-angiography/1355864.html
(13) http://www.ncbi.nlm.nih.gov/pubmed/12105357
(14) http://www.ncbi.nlm.nih.gov/pubmed/12662190
(15) http://www.ncbi.nlm.nih.gov/pubmed/20655230
(16) http://archneur.ama-assn.org/cgi/reprint/66/6/704.pdf
(17) http://www.ncbi.nlm.nih.gov/pubmed/20534374
(18) http://www.ncbi.nlm.nih.gov/pubmed/22237929
(19) http://www.ncbi.nlm.nih.gov/pubmed/22285527
II. A headache or cephalalgia is defined as a condition of pain in the region around the head or neck. Normally, it is a symptom of a number of different effects of certain diseases or the head and neck themselves. High headache impact was proven to be associated with worse academic performance.
III. Reversible cerebral vasoconstriction syndrome (RCVS)
Reversible cerebral vasoconstriction syndrome, sometimes called Call-Fleming syndrome is defined as a condition of disease of the arteries of which the brain develops a blood vessels spasm that leads to multifocal arterial constriction and dilation, causing the sudden onset of a severe headache (2)
1. Does stroke causes headache?
A sudden severe headache or recurrent of thunderclap headache may be a beginning of a stroke as a result of a hemorrhagic stroke.
2. Does headache causes stroke?
Cerebral vasoconstriction due to severe headache may cause completely stop blood flow to a portion of the brain, causing stroke if the blood vessel can not relax fast for blood to flow again(2)
II. Symptoms
1. Sudden-onset thunderclap headache or recurrent severe headache
2. Dysarthria
Dysarthria is defined as a condition of motor speech disorder resulting from neurological injury of the motor component of the motor-speech system due to the can spontaneously constriction of and relax back and forth over a period of time of cerebral arteries.
3. Nausea, Vomiting, Photophobia, Confusion and Blurred vision(3)
4. Unsteady movement of the limbs
5. Overactive or overresponsive reflexes
As a result of upper motor neuron damage causes of focal neurological symptoms.
6. Etc.
V. Causes and risk factors
Some researchers suggested reversible cerebral vasoconstriction syndrome (RCVS) may be a results from a transient disturbance of the circle of arteries that supply blood to the brain of which leads to its constriction.
1. Antidepressants
Antidepressants used to treat depression, anxiety disorders, and some personality disorders may increase risk of diffuse cerebral vasoconstriction(5)
2. Nasal decongestants
In the investigation conducted by Lariboisière Hospital of clinical, neuroimaging and outcome data of 67 consecutive patients prospectively diagnosed over 3 years in our institution with an angiographically confirmed RCVS, 43 females and 24 males with a mean age of 42 years (19-70). RCVS was spontaneous in 37% of patients and secondary in the 63% others, to postpartum in 5 and to exposure to various vasoactive substances in 37, mainly cannabis, selective serotonin-recapture inhibitors and nasal decongestants(6)
3. Eletriptan
A pediatric case of reversible cerebral vasoconstriction syndrome with cortical subarachnoid hemorrhage, suggested that Eletriptan might cause vasoconstriction of cerebral arteries. Although most patients with RCVS are adults and pediatric cases are rare, RCVS should be considered in a child complaining of severe headache(7)
4. Vasoconstrictive drug exposure and migraine
In the study of clinical, laboratory, and imaging features of patients with reversible cerebral vasoconstriction syndromes evaluated at 2 academic centers, compare subgroups, conducted by
Massachusetts General Hospital, of 139 patients with reversible cerebral vasoconstriction syndromes, found that Onset with thunderclap headache was documented in 85% and 43% developed
neurological deficits. Prior migraine was documented in 40%,
vasoconstrictive drug
exposure in 42%, and recent pregnancy in 9%. Admission computed
tomography or magnetic resonance imaging was normal in 55%; however, 81%
ultimately developed brain lesions including infarcts (39%), convexity subarachnoid hemorrhage (34%), lobar hemorrhage (20%), and brain edema (38%). Cerebral
angiographic abnormalities typically normalized within 2 months. Nearly
90% had good clinical outcome; 9% developed severe deficits; and 2%
died. In the combined cohort, calcium channel blocker therapy and
symptomatic therapy alone showed no significant effect on outcome;
however, glucocorticoid therapy showed a trend for poor outcome (P =
.08). Subgroup comparisons based on prior headache status and identified
triggers (vasoconstrictive drugs, pregnancy, other) showed no major
differences.(8)
5. Cannabis
In a report of a patient with RCVS, revealed by thunderclap headaches, involving
both internal and external carotid artery (ECA). She received fluoxetin
for depression and took a great amount of cannabis in the last months. Dr. Melki E, and the team said "While angio-MR, transcranial Doppler and CSF analysis were normal, cerebral angiography disclosed stenoses and dilatations of the middle cerebral artery. It also showed an involvement of maxillary arteries. Fluoxetin and cannabis
were stopped. After few days, she had no more headaches. At 8th week,
angiography was normalized confirming the RCVS. ECA angiogram may help
reaching a diagnosis in patients with suspected RCVS when intracerebral
abnormalities are minor or absent"(9)
7. Exposure to vasoactive substances such as angiotensin II, epinephrine, norepinephrine, vasopressin can lead to constrictor dilate of blood vessels)(4)
8. Etc.
VI. Diagnosis
A. Misdiagnosis
Reversible cerebral vasoconstriction syndrome (RCVS) constitutes an under-recognised but clinically important diagnosis, because it can be complicated by a cerebrovascular accident. The syndrome is often misdiagnosed as it resembles. Misdiagnosis of Reversible Cerebral Vasoconstriction Syndromes as primary cerebral vasculitis and aneurysmal subarachnoid hemorrhage is common because of overlapping clinical and angiographic features, researchers at Cleveland Clinic Lerner College of Medicine of Case Western Reserve University and Cleveland Clinic Foundation, said, as reversible cerebral vasoconstriction syndromes (RCVS) comprise a group of diverse conditions, all characterized by reversible multifocal narrowing of the cerebral arteries heralded by sudden (thunderclap), severe headaches with or without associated neurologic deficits(11). Other study reported demonstration of two female patients presented with severe headache with subsequent angiographic findings of ‘bead and string’ appearances of the cerebral arteries at Circle of Willis, which resolved spontaneously within 3 months. Diagnosis of reversible cerebral vasoconstriction syndrome was made. The clinical and imaging characteristics in different modalities are discussed(10)
1. Primary Angiitis of the Central Nervous System
Primary angiitis of the central nervous system is defined as an idiopathic disorder characterized by vasculitis within the dural confines. Headache and encephalopathy are the most frequent initial symptoms. Stroke or focal symptoms develop in less than 20% of patients at the onset of disease and are uncommon in the absence of headache or encephalopathy. Symptoms or signs of vasculitis outside of the central nervous system are rare; serologic markers of inflammation are typically normal(16). A Medline search was performed to identify all case reports since 1966 describing RCVS and PACNS that provide sufficient clinical detail to permit diagnostic classification according to published criteria. RCVS included case studies in which there was angiographic or transcranial Doppler ultrasound evidence of near-to-complete resolution of cerebral vasoconstriction in the absence of a well-recognized secondary cause. PACNS included reports of histologically confirmed PACNS either through biopsy or necropsy(17)
2. Post-partum cervicocephalic artery dissection (pp-CAD)
In a report of a 41-year-old right-handed African-American woman who developed the syndrome of pp-CAD (headaches, trace subarachnoid hemorrhage and diffuse cerebral arteriopathy on angiogram), researchers at the Northwestern University, hypothesized whether transient arterial wall abnormalities, postpartum hormonal changes or subtle connective tissue aberrations play a similar role in the pathogenesis of these two associated Post-partum cervicocephalic artery dissection (pp-CAD) and Reversible cerebral segmental vasoconstriction (RCSV)(16)
3. Subarachnoid Haemorrhage
Subarachnoid hemorrhage is defined as a bleeding in the subarachnoid space area between the brain and the thin tissues that cover the brain, causing certain similar symptoms to those of Reversible cerebral vasoconstriction syndrome. In the report of the case of a 51-year-old woman who presented to hospital following a thunderclap headache, initially thought to be secondary to a subarachnoid haemorrhage (SAH). A tiny anterior choroidal artery aneurysm was demonstrated on cerebral angiogram. At surgical clipping, no evidence of haemorrhage was observed. Post-operatively, the patient developed delayed right-sided hemiparesis, managed with aggressive hypertensive treatment, and later, with onset of septicaemia, central visual loss. Computed tomography (CT) brain scans demonstrated oedematous changes within the parieto-occipital regions bilaterally and later areas of infarction. The initial diagnosis of SAH was revised to reversible cerebral vasoconstriction syndrome (RCVS), which gave rise to Posterior reversible encephalopathy syndrome (PRES)(18). Another report on a pediatric case of RCVS with cortical subarachnoid hemorrhage (SAH). A 12-year-old boy developed acute, severe headache with paralysis of lower extremities causing gait disturbance after administration of eletriptan. Brain magnetic resonance angiography (MRA) revealed multifocal narrowing of the cerebral arteries, whereas magnetic resonance imaging (MRI) demonstrated sulcal hyperintensity on fluid-attenuated inversion recovery, consistent with cortical SAH. The patient's clinical symptoms resolved spontaneously after a few days and the MRI and MRA findings disappeared 3months later, suggesting a diagnosis of RCVS. Eletriptan might cause vasoconstriction of cerebral arteries. Although most patients with RCVS are adults and pediatric cases are rare, RCVS should be considered in a child complaining of severe headache.(19)
4. Orgasmic headache
Orgasmic headache (OH) is a condition of an "explosive" headache that occurs at orgasm. In a report of 34-year-old woman who presented with isolated and recurrent TCH at orgasm, which fulfilled the diagnosis of OH. However, she was post-partum and had recent exposure to ecstasy, making her symptoms highly suggestive of RCVS. Brain magnetic resonance angiography showed segmental vasoconstriction(15)
5. Etc.
B. Diagnosis
1. Catheter angiogram
Catheter angiogram, is the use of a thin plastic tube, called a catheter, is inserted into a large artery and threaded through the circulatory system to the carotid artery, through a small incision in the skin, together with X-rays and a contrast dye in visualizing the blood vessels of the brain. Then a series of radiographs is taken as the contrast agent spreads through the brain's arterial system, then a second series as it reaches the venous system.
2. CT scan
CT scan can dive your doctor a three-dimensional view of your blood vessels of the brain to look for masses and other abnormalities that cause Reversible cerebral vasoconstriction syndrome
3. Magnetic resonance imaging (MRI)
By using radio waves and magnetic fields to take pictures, MRI scan provides very high quality of a cross-sectional slice and lengthwise slices of the brain and thus providing the better and detail image of location of tumor and the surrounding structures. It is one of most likely early test ordered by a doctor to diagnose tumors, strokes, aneurysms, neurological diseases and other brain abnormalities and the blood vessels around the brain.
4. Computed tomography angiography (CTA)
CTA is a test to create detailed images of the blood vessels of the brain to look for neurological diseases and any abnormality with the use of the combination of the technology of a conventional CT scan with that of traditional angiography.
5. Cerebral magnetic resonance angiography (MRA)
Magnetic resonance angiography (MRA) is an accurate non-invasive tool for imaging the cerebral vessels. It provides morphologic information about the cerebral vessels relying on blood flow as the physical basis for generating contrast between stationary tissues and moving spins. 'Selective' MRA gives functional information about the cerebrovascular system such as flow direction, origin of flow, and presence or absence of collaterals. Arteries and veins can be imaged selectively due to their usually opposite flow directions. Although at a relatively early stage of development, MRA has already become a widely used tool for the study of the cerebrovascular system(12)
In the study of One hundred five (79%) of all 133 aneurysms detected with MRA by a neuroradiologist, 100 (75%) detected by an experienced neurosurgeon, 84 (63%) detected by a general radiologist, and 80 (60%) detected by a resident neuroradiologist, conducted by Nagatomi Neurosurgical Hospital, found that although MRA is useful in the diagnosis of cerebral aneurysms, sufficient experience and careful attention are necessary for accurate diagnosis of aneurysms located at the internal carotid and anterior cerebral arteries(13)
6. Etc.
VIII. Treatments
1. Calcium channel inhibitors (nimodipine, nifedipine or verapamil)
a. In the observation of a 63-year-old female with developed visual field impairment and a right-sided hemiparesis. Brain MRI revealed bilateral posterior and left parietal ischaemic strokes and Cerebral catheter angiography showed segmental arterial vasoconstriction, after 11 days onset of headache, a vasodilative therapy with calcium channel inhibitors was started and serial transcranial Doppler ultrasonography demonstrated resolution of cerebral arterial vasoconstriction(14)
b. Side effects are not limit to
b.1. Constipation
b.2. Nausea,
b.3 Headache
b.4. Rash,
b.5. Edema
b.6. Low blood pressure
b.7. Drowsiness, and dizziness
b.8. Etc.
2. Corticosteroids
a. Corticosteroids (commonly called steroids) are synthetic medicine closely resemble cortisol, a hormone produced adrenal glands produce naturally. In the report of a severe case of a 53-year-old woman with RCVS having an unruptured cerebral aneurysm and presenting as cortical subarachnoid hemorrhage, reversible posterior leukoencephalopathy syndrome, and cerebral infarction, by Juntendo University Shizuoka Hospital showed that the patient was successfully treated with corticosteroids and a calcium channel blocker and the aneurysm was clipped. Her various complications are due to the responsible vasoconstriction that started distally and progressed towards proximal arteries. This case demonstrates the spectrum of presentations of RCVS, a clinically complicated condition(20)
b. Side effects are not limit to
b.1. Bones thinning,
b.2. Avascular necrosis of bones
b.3. Swelling of the face
b.4. The medicine can inhibit natural hormones
b.5. It may cause liver damage
b.6. It may lower HDL cholesterol, and raise LDL cholesterol
b.7. Etc.
3. Intravenous magnesium sulfate
a. Magnesium sulfateis is a chemical compound with the formula MgSO4. In the report of four postpartum women aged 15 to 33 years developed acute neurologic deficits 1 to 8 days after uncomplicated deliveries. One had a history of migraine headaches and 2 had histories of spontaneous abortion. Two of the patients had uneventful pregnancies and 2 had preeclampsia, 1 of whom had acute hepatic failure, conducted by Jennifer E and the team showed that aggressive treatment was attempted with most patients including intravenous magnesium sulfate, corticosteroids, calcium channel blockers, balloon angioplasty, vasopressors, and osmotic agents. Two patients underwent serial angiography, with results showing severe, recurrent proximal vasoconstriction involving all major intracranial vessels.
b. Side Effects are not limit to
b.1. It may cause severe allergic reactions, including rash; hives; itching; difficulty breathing; tightness in the chest swelling of the mouth, face, lips, or tongue.
b.2. Dizziness
b.3. Flushing;
b.4. Irregular heartbeat
b.5. Sweating
b.6. Etc.
4. Etc.
Natural Remedies for Dementia Memory Loss Reversal
Guarantee to Stop Progression and Reverse Memory Loss in Alzheimer and Dementia with step by step instructions through Scientific Studies within 2 Months or your Money back
Super foods Library, Eat Yourself Healthy With The Best of the Best Nature Has to Offer
For over 100 healthy recipes, http://diseases-researches.blogspot.ca/p/blog-page_17.html
Sources
(1) http://www.ncbi.nlm.nih.gov/pubmed/20816453
(2) http://www.ncbi.nlm.nih.gov/pubmed/19220301
(3) http://www.ncbi.nlm.nih.gov/pubmed/20936928
(4) http://www.ncbi.nlm.nih.gov/pubmed/21179608
(5) http://www.ncbi.nlm.nih.gov/pubmed/16832100
(6) http://www.ncbi.nlm.nih.gov/pubmed/18025032
(7) http://www.sciencedirect.com/science/article/pii/S038776041200006X
(8) http://www.medscape.org/viewarticle/748234_3
(9) http://www.ncbi.nlm.nih.gov/pubmed/22000400
(10) http://www.hkcr.org/publ/Journal/vol13no3/full/149-53%20Imaging.pdf
(11) http://www.ncbi.nlm.nih.gov/pubmed?term=Narrative%20Review%3A%20Reversible%20Cerebral%20Vasoconstriction%20Syndromes
(12) http://www.biomedsearch.com/nih/Cerebral-magnetic-resonance-angiography/1355864.html
(13) http://www.ncbi.nlm.nih.gov/pubmed/12105357
(14) http://www.ncbi.nlm.nih.gov/pubmed/12662190
(15) http://www.ncbi.nlm.nih.gov/pubmed/20655230
(16) http://archneur.ama-assn.org/cgi/reprint/66/6/704.pdf
(17) http://www.ncbi.nlm.nih.gov/pubmed/20534374
(18) http://www.ncbi.nlm.nih.gov/pubmed/22237929
(19) http://www.ncbi.nlm.nih.gov/pubmed/22285527
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