Disseção da Artéria Cerebelosa Superior numa Doente Diagnosticada com Síndrome de Vasoconstrição Cerebral Reversível: Um Caso Clínico

Autores

  • Tiago Pedro Department of Neuroradiology, Centro Hospitalar Universitário de São João, E.P.E., Porto, Portugal https://orcid.org/0000-0003-3953-9049
  • Ruben Maia Department of Neuroradiology, Centro Hospitalar Universitário de São João, E.P.E., Porto, Portugal
  • Rafaela Costa Department of Neurology, Centro Hospitalar Universitário de São João, E.P.E., Porto, Portugal; Department of Clinical Neurosciences and Mental Health, Faculty of Medicine of University of Porto, Portugal
  • Bárbara Martins Department of Neurology, Centro Hospitalar Universitário de São João, E.P.E., Porto, Portugal; Department of Clinical Neurosciences and Mental Health, Faculty of Medicine of University of Porto, Portugal
  • Joana Ribeiro Department of Medicine, Centro Hospitalar do Médio Tejo, E.P.E., Tomar, Portugal
  • Rui Domingues Department of Medicine, Hospital de Braga, E.P.E., Braga, Portugal
  • Teresa Brito Department of Medicine, Centro Hospitalar Universitário de São João, E.P.E., Porto, Portugal
  • Pedro Abreu Department of Neurology, Centro Hospitalar Universitário de São João, E.P.E., Porto, Portugal; Department of Clinical Neurosciences and Mental Health, Faculty of Medicine of University of Porto, Portugal
  • Pedro Castro Department of Neurology, Centro Hospitalar Universitário de São João, E.P.E., Porto, Portugal; Department of Clinical Neurosciences and Mental Health, Faculty of Medicine of University of Porto, Portugal; Cardiovascular Research and Development Unit, Faculty of Medicine of University of Porto, Portugal
  • Ricardo Soares-dos-Reis Department of Neurology, Centro Hospitalar Universitário de São João, E.P.E., Porto, Portugal; Department of Clinical Neurosciences and Mental Health, Faculty of Medicine of University of Porto, Portugal; i3s - institute for research and innovation in health, University of Porto, Portugal

DOI:

https://doi.org/10.46531/sinapse/CC/220056/2022

Palavras-chave:

Artérias Cerebrais, COVID-19, Doenças Arteriais Cerebrais/ complicações, Perturbações Cerebrovascular, Vasoconstrição

Resumo

A dissecção arterial é uma complicação rara da síndrome de vasoconstrição cerebral reversível (RCVS). Descrevemos o caso de uma mulher de 35 anos com história de enxaqueca recorrente e sinais neurológicos focais, incluindo hemiataxia direita. Ela tinha sido diagnosticada com a doença COVID-19 duas semanas antes. A neuroimagem revelou estenose multifocal das artérias da circulação posterior e dissecção da artéria cerebelosa superior direita. A doente melhorou significativamente durante a sua hospitalização e manteve apenas ligeira ataxia. A interação entre a doença COVID-19, RCVS, e a dissecção arterial requer mais investigação.

Downloads

Não há dados estatísticos.

Referências

Singhal AB, Hajj-Ali RA, Topcuoglu MA, Fok J, Bena J, Yang D, et al. Reversible cerebral vasoconstriction syndromes: analysis of 139 cases. Arch Neurol. 2011;68:1005-12. doi: 10.1001/archneurol.2011.68.

Singhal AB. Posterior Reversible Encephalopathy Syndrome and Reversible Cerebral Vasoconstriction Syndrome as Syndromes of Cerebrovascular Dysregulation. Continuum (Minneap Minn). 2021;27:1301-20. doi: 10.1212/

CON.0000000000001037.

Chen SP, Fuh JL, Chang FC, Lirng JF, Shia BC, Wang SJ.

Transcranial color doppler study for reversible cerebral vasoconstriction syndromes. Ann Neurol. 2008;63:751-7. doi: 10.1002/ana.21384.

Fugate JE, Rabinstein AA. Posterior reversible encephalopathy syndrome: clinical and radiological manifestations, pathophysiology, and outstanding questions. Lancet Neurol. 2015;14:914-925. doi: 10.1016/S1474-4422(15)00111-8.

Mawet J, Boukobza M, Franc J, Sarov M, Arnold M, Bousser MG, et al. Reversible cerebral vasoconstriction syndrome and cervical artery dissection in 20 patients. Neurology. 2013;81:821-4. doi: 10.1212/WNL.0b013e3182a2cbe2.

Gotoh H, Takahashi T, Shimizu H, Ezura M, Tominaga T. Dissection of the superior cerebellar artery: a report of two cases and review of the literature. J Clin Neurosci. 2004;11:196-9. doi: 10.1016/s0967-5868(03)00136-x.

Gencler OS, Ege MR, Aslan A. Unilateral common carotid artery dissection in a patient with recent COVID-19: An association or a coincidence? J Clin Neurosci. 2021;87:26-28. doi: 10.1016/j.jocn.2021.02.010.

Patel P, Khandelwal P, Gupta G, Singla A. COVID-19 and cervical artery dissection- A causative association? J Stroke Cerebrovasc Dis. 2020;29:105047. doi: 10.1016/j.jstrokecerebrovasdis.2020.105047.

Purdy K, Long R, Jickling G. Case Report: COVID-19 Infection and Cervical Artery Dissection. Am J Trop Med Hyg. 2022;106:874-6. doi: 10.4269/ajtmh.21-0999.

Chang J, Le P. A case of carotid artery dissection in a patient with post-covid-19 syndrome. Chest. 2021;160:A860. doi: 10.1016/j.chest.2021.07.806. [11] Debette S, Leys D. Cervical-artery dissections: predisposing factors, diagnosis, and outcome. Lancet Neurol. 2009;8:668-78. doi: 10.1016/ S1474-4422(09)70084-5.

Dakay K, Kaur G, Gulko E, Santarelli J, Bowers C, Mayer SA, et al. Reversible cerebral vasoconstriction syndrome and dissection in the setting of COVID-19 infection. J Stroke Cerebrovasc Dis. 2020;29:105011. doi: 10.1016/j.jstroke-cerebrovasdis.2020.105011.

Mansoor T, Alsarah AA, Mousavi H, Khader Eliyas J, Girotra T, Hussein O. COVID-19 Associated Reversible Cerebral Vasoconstriction Syndrome Successfully Treated with Nimodipine and Aspirin. J Stroke Cerebrovasc Dis. 2021;30:105822. doi: 10.1016/j.jstrokecerebrovasdis.2021.105822.

Vieira C, Nery L, Martins L, Jabour L, Dias R, Simões E Silva AC. Downregulation of Membrane-bound Angiotensin Converting Enzyme 2 (ACE2) Receptor has a Pivotal Role in COVID-19 Immunopathology. Curr Drug Targets. 2021;22:254-81. doi: 10.2174/1389450121666201020154033.

Downloads

Publicado

2024-04-20

Como Citar

1.
Pedro T, Maia R, Costa R, Martins B, Ribeiro J, Domingues R, et al. Disseção da Artéria Cerebelosa Superior numa Doente Diagnosticada com Síndrome de Vasoconstrição Cerebral Reversível: Um Caso Clínico. Sinapse [Internet]. 20 de Abril de 2024 [citado 21 de Dezembro de 2024];22(4):169-72. Disponível em: https://sinapse.pt/index.php/journal/article/view/51

Edição

Secção

Casos Clínicos