The clinical spectrum of reversible cerebral vasoconstriction syndrome: The Italian Project on Stroke at Young Age (IPSYS)

被引：24

作者：

Caria, Filomena ^{[1
]}

Zedde, Marialuisa ^{[2
]}

Gamba, Massimo ^{[3
]}

Bersano, Anna ^{[4
]}

Rasura, Maurizia ^{[5
]}

Adami, Alessandro ^{[6
]}

Piantadosi, Carlo ^{[7
]}

Quartuccio, Luca ^{[8
]}

Azzini, Cristiano ^{[9
,56
]}

Melis, Maurizio ^{[10
]}

Delodovici, Maria Luisa ^{[11
]}

Dallocchio, Carlo ^{[12
]}

Gandolfo, Carlo ^{[13
]}

Cerrato, Paolo ^{[14
]}

Motto, Cristina ^{[15
]}

Melis, Fabio ^{[16
]}

Chiti, Alberto ^{[17
]}

Gentile, Mauro ^{[18
]}

Bignamini, Valeria ^{[19
]}

Morotti, Andrea ^{[20
,51
]}

Lotti, Enrico Maria ^{[21
,55
]}

Toriello, Antonella ^{[22
,46
]}

Costa, Paolo ^{[23
]}

Silvestrelli, Giorgio ^{[24
,53
]}

Zini, Andrea ^{[25
]}

De Giuli, Valeria ^{[1
]}

Poli, Loris ^{[1
]}

Paciaroni, Maurizio ^{[26
,27
,47
]}

Lodigiani, Corrado ^{[28
,37
]}

Marcheselli, Simona ^{[29
,38
]}

Sanguigni, Sandro ^{[30
]}

Del Sette, Massimo ^{[31
]}

Monaco, Serena ^{[32
]}

Lochner, Piergiorgio ^{[33
]}

Zanferrari, Carla ^{[34
]}

Anticoli, Sabrina ^{[35
]}

Padovani, Alessandro ^{[1
]}

Pezzini, Alessandro ^{[1
]}

Giossi, Alessia ^{[36
]}

Sessa, Maria ^{[36
]}

Gilberti, Nicola ^{[3
]}

Magoni, Mauro ^{[3
]}

Ferrazzi, Paola ^{[37
]}

Libre, Luca ^{[37
]}

Di Pilla, Marina ^{[37
]}

Corato, Manuel ^{[38
]}

Spalloni, Alessandra ^{[5
]}

Patella, Rosalba ^{[5
]}

Di Lisi, Filomena ^{[5
]}

Calabro, Rocco Salvatore ^{[39
]}

机构：

[1] Univ Brescia, Clin Neurol, Dipartimento Sci Clin & Sperimentali, P Spedali Civili 1, I-25123 Brescia, Italy

[2] IRCCS Reggio Emilia, Azienda Unita Sanit Locale, SC Neurol, Reggio Emilia, Italy

[3] Spedali Civili Brescia, Neurol Vasc, Stroke Unit, Brescia, Italy

[4] Fdn IRCCS Ist Neurol Carlo Besta, UO Malattie Cerebrovasc, Milan, Italy

[5] Univ Roma La Sapienza, Azienda Osped St Andrea, Stroke Unit, Rome, Italy

[6] Osped Sacro Cuore Negrar, Dipartimento Neurol, Stroke Ctr, Verona, Italy

[7] Azienda Osped San Giovanni Addolorata, UOC Neurol, Rome, Italy

[8] Azienda Osped Univ Santa Maria Misericordia, Dipartimento Area Med, Clin Reumatol, Udine, Italy

[9] Azienda Osped Univ Ferrara, Dipartimento Neurosci & Riabil, UO Neurol, Ferrara, Italy

[10] Azienda Osped G Brotzu, Dipartimento Neurosci & Riabil, SC Neurol & Stroke Unit, Cagliari, Italy

[11] Univ Insubria, Osped Circolo, Unita Neurol, Varese, Italy

[12] ASST Pavia, UOC Neurol, Dipartimento Area Med, Voghera, Italy

[13] Univ Genoa, Dipartimento Neurosci Riabil Oftalmol Genet & Sci, Genoa, Italy

[14] Univ Torino, Stroke Unit, Dipartimento Neurosci, Turin, Italy

[15] Azienda Osped Niguarda Ca Granda, Dipartmento Sci Neurol, Stroke Unit, Milan, Italy

[16] ASL Citta Torino, SS NeuroVasc Osped Maria Vittoria, Turin, Italy

[17] Azienda Osped Univ Pisana, UO Neurol, Pisa, Italy

[18] Osped Santa Maria Misericordia, UO Neurol Stroke Unit, Rovigo, Italy

[19] Osped S Chiara, UO Neurol, Stroke Unit, Trento, Italy

[20] IRCCS Fdn Mondino, UC Malattie Cerebrovasc, Pavia, Italy

[21] AUSL Romagna, Unita Operat Complessa Neurol, Ravenna, Italy

[22] Azienda Osped Univ San Giovanni di Dio & Ruggi dA, Unita Operat Complessa Neurol, Salerno, Italy

[23] Ist Osped Poliambulanza, UO Neurol, Brescia, Italy

[24] Osped Carlo Poma, Dipartimento Neurosci, Stroke Unit, Mantua, Italy

[25] AUSL Modena, Nuovo Osped Civile S Agostino Estense, Clin Neurol, Stroke Unit, Modena, Italy

[26] Univ Perugia, Stroke Unit, Perugia, Italy

[27] Univ Perugia, Div Med Cardiovasc, Perugia, Italy

[28] IRCCS, Humanitas Clin & Res Ctr, Ctr Trombosi & Malattie Emorrag, Rozzano Milano, Italy

[29] IRCCS, Humanitas Clin & Res Ctr, Neurol Urgenza & Stroke Unit, Rozzano Milano, Italy

[30] Osped Madonna Soccorso, Dipartmento Neurol, San Benedetto Tronto, Italy

[31] EO Osped Galliera, Unita Neurol, Genoa, Italy

[32] Osped Civico, Stroke Unit, Palermo, Italy

[33] Saarland Univ, Med Ctr, Dipartimento Neurol, Homburg, Germany

[34] ASST Melegnano Martesana, UOC Neurol, Vizzolo Predabissi, Italy

[35] Osped S Camillo Forlanini, Dipartimento Emergenza Urgenza, Stroke Unit, Rome, Italy

[36] Ist Ospitalieri, UO Neurol, Cremona, Italy

[37] Univ La Sapienza, Ctr Trombosi & Malattie Emorrag, Rozzano Milano, Italy

[38] Univ La Sapienza, Neurol Urgenza & Stroke Unit, Rozzano Milano, Italy

[39] Policlin Univ, Ctr Neurolesi Bonino Pulejo, Ist Ricovero & Cura Carattere Sci, Messina, Italy

[40] Univ Messina, Clin Neurol, Dipartimento Neurosci Sci Psichiat & Anestesiol, Messina, Italy

[41] Osped S Andrea, Unita Neurol, La Spezia, Italy

[42] Osped Galliera, UO Neurol, Genoa, Italy

[43] Azienda Osped Univ Borgo Trento, UO Neurol, Verona, Italy

[44] IRCCS Ist Neurol Mediterraneo, NEUROMED, Dipartimento Epidemiol & Prevenz, Lab Epidemiol Mol & Nutr, Pozzilli, Italy

[45] Univ Pavia, Unita Stat Med & Genom, Dipartimento Sci Sistema Nervoso & Comportamento, Pavia, Italy

[46] AO Univ San Giovanni di Dio & Ruggi dAragona, UOC Neurol, Salerno, Italy

[47] Univ Perugia, Div Med Cardiovasc, Stroke Unit, Perugia, Italy

[48] Osped Valduce, UOC Neurol, Como, Italy

[49] Azienda Ospedaliera Osped St Anna, UO Neurol, Como, Italy

[50] IRCCS Osped S Raffaele, UO Neurol, Stroke Unit, Milan, Italy

来源：

CEPHALALGIA | 2019年 / 39卷 / 10期

关键词：

Reversible cerebral vasoconstriction syndrome (RCVS); thunderclap headache; stroke; THUNDERCLAP;

D O I：

10.1177/0333102419849013

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Introduction To describe clinical, neuroimaging, and laboratory features of a large cohort of Italian patients with reversible cerebral vasoconstriction syndrome. Methods In the setting of the multicenter Italian Project on Stroke at Young Age (IPSYS), we retrospectively enrolled patients with a diagnosis of definite reversible cerebral vasoconstriction syndrome according to the International Classification of Headache Disorders (ICHD)-3 beta criteria (6.7.3 Headache attributed to reversible cerebral vasoconstriction syndrome, imaging-proven). Clinical manifestations, neuroimaging, treatment, and clinical outcomes were evaluated in all patients. Characteristics of reversible cerebral vasoconstriction syndrome without typical causes ("idiopathic reversible cerebral vasoconstriction syndrome") were compared with those of reversible cerebral vasoconstriction syndrome related to putative causative factors ("secondary reversible cerebral vasoconstriction syndrome"). Results A total of 102 patients (mean age, 47.2 +/- 13.9 years; females, 85 [83.3%]) qualified for the analysis. Thunderclap headache at presentation was reported in 69 (67.6%) patients, and it typically recurred in 42 (60.9%). Compared to reversible cerebral vasoconstriction syndrome cases related to putative etiologic conditions (n = 21 [20.6%]), patients with idiopathic reversible cerebral vasoconstriction syndrome (n = 81 [79.4%]) were significantly older (49.2 +/- 13.9 vs. 39.5 +/- 11.4 years), had more frequently typical thunderclap headache (77.8% vs. 28.6%) and less frequently neurological complications (epileptic seizures, 11.1% vs. 38.1%; cerebral infarction, 6.1% vs. 33.3%), as well as concomitant reversible brain edema (25.9% vs. 47.6%). Conclusions Clinical manifestations and putative etiologies of reversible cerebral vasoconstriction syndrome in our series are slightly different from those observed in previous cohorts. This variability might be partly related to the coexistence of precipitating conditions with a putative etiologic role on disease occurrence.

引用

页码：1267 / 1276

页数：10

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