Superior Cerebellar Artery Dissection in a Patient Diagnosed with Reversible Cerebral Vasoconstriction Syndrome: A Case Report

Authors

  • 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

Keywords:

Cerebral Arterial Diseases/ complications, Cerebral Arteries, Cerebrovascular Disorders, COVID-19, Vasoconstriction

Abstract

Arterial dissection is an uncommon complication of reversible cerebral vasoconstriction syndrome (RCVS). We describe the case of a 35-year-old woman with a migraine history who presented with recurrent thunderclap headache and focal neurological signs, including right hemiataxia. She had been diagnosed with COVID-19 disease two weeks earlier. Neuroimaging revealed multifocal stenosis of the posterior circulation arteries and dissection of the right superior cerebellar artery. She improved significantly throughout her one-week hospitalization and maintained only mild ataxia. The interplay between COVID-19 disease, RCVS, and arterial dissection requires further investigation.

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References

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.

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Published

2024-04-20

How to Cite

1.
Pedro T, Maia R, Costa R, Martins B, Ribeiro J, Domingues R, et al. Superior Cerebellar Artery Dissection in a Patient Diagnosed with Reversible Cerebral Vasoconstriction Syndrome: A Case Report. Sinapse [Internet]. 2024 Apr. 20 [cited 2024 Dec. 21];22(4):169-72. Available from: https://sinapse.pt/index.php/journal/article/view/51