Internal medicine

Radiology

Reversible cerebral vasoconstriction syndrome

Psychiatry

Magnetic resonance imaging

Cardiology

Surgery

Cerebral arteries

Subarachnoid hemorrhage

Posterior reversible encephalopathy syndrome

Vasoconstriction

Headaches

Cerebral edema

Anesthesia

Neuroimaging

Medicine

La radiologia medica

Reversible cerebral vasoconstriction syndrome (RCVS) is a group of disorders characterized by segmental narrowing and dilatation of medium-to-large cerebral arteries, clinically presenting with recurrent episodes of sudden-onset thunderclap headaches, with or without focal neurological deficits. Cerebral vasoconstriction is typically reversible, with spontaneous resolution within 3 months. Although the syndrome has generally a benign course, patients with neurological deficits may experience worse outcome. The main imaging finding is segmental constriction of intracranial arteries, which can be associated with subarachnoid hemorrhage and/or ischemic foci. Other possible findings are intracranial hemorrhage, subdural bleeding and cerebral edema. The latter may have a pattern which can resemble that of posterior reversible encephalopathy syndrome, a condition that can overlap with RCVS. New imaging techniques, such as vessel wall imaging and arterial spin labeling, are proving useful in RCVS and are giving new insights into the pathophysiology of this condition. In this paper, we aim to review neuroimaging findings of RCVS.

Reversible cerebral vasoconstriction syndrome: review of neuroimaging findings