中国实用神经疾病杂志2025，Vol.28Issue(3)：300-304,5.DOI:10.12083/SYSJ.240634
可逆性脑血管收缩综合征60例临床分析
Clinical analysis of reversible cerebral vasoconstriction syndrome in 60 patients
摘要
Abstract
Objective To analyze the clinical features and prognosis of reversible cerebral vasoconstriction syndrome(RCVS)patients.Methods The clinical data of Chinese RCVS cases reported in domestic and foreign journals from January 2014 to February 2024 were collected,combined with 2 cases diagnosed and treated in the Affiliated Changsha Central Hospital,University of South China.Results There were 60 RCVS patients in all.The age of onset is 20-64(40.7±12.8)years old.Sixty percent of the patients suffered from RCVS before the age of 40.The most common trigger is bathing,and the most common initial symptom is recurrent thunderclap headache,often accompanied by elevated blood pressure,nausea and vomiting,epileptic seizures,unilateral limb weakness,visual impairment,speech impairment,and cognitive impairment.They had bilateral headache or unilateral headache.There was no significant difference in headache location(P＜0.05).Five percent of the patients have no headache during the disease.Thirty-seven patients performed MRA/CTA.There were 24 cases with diffuse segmental stenosis of intracranial arteries,9 cases with anterior circulation segmental stenosis,2 cases with posterior circulation segmental stenosis,and 2 cases with abnormal extracranial vascular.Only ten patients performed digital subtraction angiography(DSA)to confirm multiple focal cerebral artery stenosis.Fifty-eight patients were treated with nimodipine,while 2 cases did not receive medication but avoided the cause.All the patients of the clinical symptoms and vascular imaging abnormalities thoroughly restored.Conclusion The incidence is higher in women under the age of 40 in the patients with RCVS.Recurrent thunderclap headache is the most common initial symptom.It may be accompany by symptoms such as elevated blood pressure,nausea and vomiting,epileptic seizures,and focal neurological deficits.There may also be no headache throughout the disease process.Both intracranial and extracranial vascular may be affected.It'll receive a good prognosis by nimodipine.关键词
可逆性脑血管收缩综合征/霹雳性头痛/临床表现/血管影像/预后Key words
Reversible cerebral vasoconstriction syndrome/Thunderclap headache/Clinical feature/Vascular imaging/Prognosis分类
临床医学引用本文复制引用
陈素芬,唐建生,胡珏,宋康平,李璋麟..可逆性脑血管收缩综合征60例临床分析[J].中国实用神经疾病杂志,2025,28(3):300-304,5.基金项目
湖南省自然科学基金项目(编号:2023JJ40072) （编号:2023JJ40072）
