Reversible cerebral vasoconstriction syndrome following carotid stenting
Reversible cerebral vasoconstriction syndrome following carotid stenting
复制标题
颈动脉支架置入术后可逆性脑血管收缩综合征
DOI：
10.1212/wnl.0000000000000677
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发表时间：
2014
期刊：
影响因子：
9.9
通讯作者：
B. Molyneaux
中科院分区：
文献类型：
--
作者：
A. Aghaebrahim;A. Jadhav;Yumna Saeed;R. Totoraitis;B. Jankowitz;T. Jovin;B. Molyneaux
一位服用文拉法辛的60岁女性患者在接受右侧颈总动脉支架置入术1个月后出现头痛和左侧无力。基于导管的血管造影术发现右侧大脑前动脉和右侧大脑中动脉出现新的异常(图A-C)。关于脉管炎的调查，包括脑脊液研究，并不引人注目。动脉内注射维拉帕米后，血管不规则和症状改善(图D-F)。单侧可逆性脑血管收缩综合征曾在颈动脉内膜切除术后被描述过。其机制尚不清楚，但可能是由于大脑自我调节功能障碍。1，2同时使用5-羟色胺和去甲肾上腺素再摄取抑制剂可能是易感因素。
A 60-year-old woman on venlafaxine presented with headache and left-sided weakness 1 month after undergoing right common carotid artery stenting. Catheter-based angiogram identified new irregularities of the right anterior cerebral and right middle cerebral artery (figure, A–C). Investigations for vasculitis, including CSF studies, were unremarkable. The vessel irregularities and symptoms improved after administration of intra-arterial verapamil (figure, D–F). Unilateral reversible cerebral vasoconstriction syndrome has previously been described after carotid endarterectomy. The mechanism is unclear; however, it may be due to disturbance of cerebral autoregulation.1,2 Concomitant use of a serotonin and norepinephrine reuptake inhibitor may have been a predisposing factor.