Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2025
Reversible cerebral vasoconstriction syndrome presenting as thunderclap headache following high-altitude exposure and coca leaf tea consumption.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Del Brutto Oscar H, Guzmán Eduardo J, Caputi Rafael, Rumbea Denisse A, Del Brutto Víctor J
Аннотация
BACKGROUND: Reversible cerebral vasoconstriction syndrome (RCVS) is a rare cause of thunderclap headache, often triggered by environmental or pharmacologic stressors.
METHODS: A 56-year-old women presented with thunderclap headache and focal neurological signs following high-altitude exposure and coca leaf tea consumption RESULTS: Neuroimaging demonstrated acute ischemic lesions in different arterial territories and severe narrowing of all medium-diameter intracranial arteries. She was started on dual antiplatelet therapy, intravenous fluids, and was instructed to remain in bed in a strictly flat position. Repeated MRI showed marked improvement of both ischemic lesions and the arterial vasospasm.
CONCLUSION: High-altitude hypoxia and sympathomimetic alkaloids may synergistically precipitate RCVS. Awareness of traditional remedies and environmental exposures is essential in evaluating acute neurological syndromes in travelers.
METHODS: A 56-year-old women presented with thunderclap headache and focal neurological signs following high-altitude exposure and coca leaf tea consumption RESULTS: Neuroimaging demonstrated acute ischemic lesions in different arterial territories and severe narrowing of all medium-diameter intracranial arteries. She was started on dual antiplatelet therapy, intravenous fluids, and was instructed to remain in bed in a strictly flat position. Repeated MRI showed marked improvement of both ischemic lesions and the arterial vasospasm.
CONCLUSION: High-altitude hypoxia and sympathomimetic alkaloids may synergistically precipitate RCVS. Awareness of traditional remedies and environmental exposures is essential in evaluating acute neurological syndromes in travelers.