Reversible cerebral vasoconstriction syndrome presenting as an isolated primary intraventricular hemorrhage

Katarina Dakay,Shadi Yaghi,Ryan A Mctaggart,Linda C Wendell,Mahesh V Jayaraman

doi:10.1186/s41016-018-0118-7

Abstract

BackgroundPrimary intraventricular hemorrhage is an uncommon cause of stroke and is often associated with longstanding, uncontrolled hypertension. Reversible cerebral vasoconstriction is also an uncommon condition characterized by reversible constriction of intracerebral vessels, which can lead to ischemic or hemorrhagic strokes.Case presentationWe describe a case of isolated primary intraventricular hemorrhage secondary to reversible cerebral vasoconstriction syndrome triggered by pseudoephedrine.ConclusionsReversible cerebral vasoconstriction syndrome is a rare cause of primary intraventricular hemorrhage and should be considered in the differential in angiography-negative IVH when there is a history of vasoactive substance use.

Highlights

Primary intraventricular hemorrhage is an uncommon cause of stroke and is often associated with longstanding, uncontrolled hypertension
Reversible cerebral vasoconstriction syndrome (RCVS) is an uncommon condition of reversible vasospasm of intracerebral vessels which manifests as a thunderclap headache, focal neurologic deficits and often both ischemic and hemorrhagic strokes including subarachnoid hemorrhage
Primary intraventricular hemorrhage (IVH) is a rare cause of intracerebral hemorrhage; it accounts for 3.1% of hemorrhagic strokes [2] and 0.31% of all strokes [3]

Summary

Introduction

Primary intraventricular hemorrhage is an uncommon cause of stroke and is often associated with longstanding, uncontrolled hypertension. Background Reversible cerebral vasoconstriction syndrome (RCVS) is an uncommon condition of reversible vasospasm of intracerebral vessels which manifests as a thunderclap headache, focal neurologic deficits and often both ischemic and hemorrhagic strokes including subarachnoid hemorrhage. * Correspondence: linda_wendell@brown.edu 3Department of Neurology, Neurosurgery and Medical Education, Rhode Island Hospital/The Warren Alpert Medical School of Brown University, 593 Eddy St APC 712, Providence, RI 02903, USA Full list of author information is available at the end of the article is the first case reported of RCVS causing isolated intraventricular hemorrhage.

Results

Conclusion