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Correspondence |

Reversible Cerebral Vasoconstriction Syndrome and Hemorrhagic Events: Who Precedes Whom?

Hongliang Zhang, MD; Xiaoke Wang, MD; Yi Yang, MD, PhD; Jiang Wu, MD, PhD
Arch Neurol. 2011;68(12):1614-1615. doi:10.1001/archneur.68.12.1614-b.
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Singhal et al1 reported a cohort of 139 patients with reversible cerebral vasoconstriction syndrome (RCVS) and concluded that patients with RCVS have a unique set of clinical imaging features, with no significant differences between subgroups. This study again reveals a high incidence of hemorrhagic events in RCVS. However, we have some concern regarding the causes of hemorrhagic complications in RCVS.

Initially, RCVS was described to characterize patients with thunderclap headaches and reversible segmental vasoconstriction of the intracranial vessels. According to current knowledge, RCVS is a clinical and radiologic syndrome characterized by thunderclap headache; transient, multifocal, and segmental vasoconstriction of cerebral arteries lasting weeks to months; and focal neurological symptoms. Although RCVS has been reported frequently in the literature, most studies on RCVS are observational; thus, the etiology and the underlying mechanism remain largely unknown.

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December 1, 2011
Aneesh B. Singhal, MD
Arch Neurol. 2011;68(12):1614-1615. doi:10.1001/archneur.68.12.1615-a.
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