Delayed Positivization of Cerebral Angiography in Reversible Cerebral
Vasoconstriction Syndrome (RCVS) Presenting with Recurrent Subarachnoid
Luca Quartuccio*, 1, §, Francesco Tuniz2, §, Benedetto Petralia3, Bruno Zanotti2, Miran Skrap2, Salvatore De Vita1
1 Clinic of Rheumatology, Azienda Ospedaliero-Universitaria di Udine, DSMB, Italy
2 Department of Neurosurgery, Azienda Ospedaliero-Universitaria di Udine, Italy
3 Department of Neuroradiology, Azienda Ospedaliero-Universitaria di Udine, Italy
Benign angiopathy of the central nervous system is a clinical syndrome with evidence of reversible cerebral vasoconstriction (RCVS). Haemorrhagic stroke, either subarachnoid or intracerebral is an unusual presentation of RCVS. We describe a case of RCVS presenting with a subarachnoid haemorrhage (SAH), with rebleeding and onset of hydrocephalus during the first week, and, notably, delayed evidence of typical angiographic features after two negative prior exams. Normalization of the angiographic vasculitic-like lesions was documented at month +6. Repeated cerebral angiograms are mandatory to exclude this kind of disease, and the uncommon presentation of this case reinforces this concept.
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* Address correspondence to this author at the Clinic of Rheumatology, DSMB,
University of Udine, Univerisyt Hospital “Santa Maria della Misericordia”,
Udine, Piazzale Santa Maria della Misericordia, 15, Italy; Tel: 0039 0432
559352; Fax: 0039 0432 559472;
E-mail: firstname.lastname@example.org§L. Quartuccio and F. Tuniz equally collaborated to this work.