Cerebral vasomotor reactivity in reversible cerebral vasoconstriction syndrome

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dc.citation.issue6
dc.citation.volume37
dc.contributor.authorTopcuoglu, Mehmet Akif
dc.contributor.authorChan, Suk-tak
dc.contributor.authorSilva, Gisele Sampaio [UNIFESP]
dc.contributor.authorSmith, Eric Edward
dc.contributor.authorKwong, Kenneth K.
dc.contributor.authorSinghal, Aneesh Bhim
dc.coverageLondon
dc.date.accessioned2020-07-13T11:53:24Z
dc.date.available2020-07-13T11:53:24Z
dc.date.issued2017
dc.description.abstractBackground: Altered cerebrovascular tone is implicated in reversible cerebral vasoconstriction syndrome (RCVS). We evaluated vasomotor reactivity using bedside transcranial Doppler in RCVS patients. Methods: In this retrospective case-control study, middle cerebral artery (MCA) blood flow velocities were compared at rest and in response to breath-hold in RCVS (n=8), Migraineurs (n=10), and non-headache Controls (n=10). Hyperventilation response was measured in RCVS. Results: In RCVS, Breath Holding Index (BHI) was severely reduced in seven of eight patients and 14/16 MCAsen
dc.description.abstractseven of 16 MCAs showed exhausted (BHI<0.1) or inverted (BHI<0) vasomotor reactivity. Mean BHI in RCVS (0.23 +/- 0.5) was significantly lower than Migraine (1.52 +/- 0.57) and Controls (1.51 +/- 0.32), p<0.001. Triphasic velocity responses were seen in all groups. The maximum V-mean decline during the middle negative phase was -15.5 +/- 9.2% in RCVS, -15.4 +/- 7% in Migraine, and -10.3 +/- 5% in Controls (p=0.04). In the late positive phase, average V-mean increase was 6.2 +/- 14% in RCVS, which was significantly lower (p<0.001) than Migraine (30.5 +/- 11%) and Controls (30.2 +/- 6%). With hyperventilation, RCVS patients showed 23% decrease in V-mean. Conclusion: Cerebral arterial tone is abnormal in RCVS, with proximal vasoconstriction and abnormally reduced capacity for vasodilation. Further studies are needed to determine the utility of BHI to diagnose RCVS before angiographic reversibility is established, and to estimate prognosis.en
dc.description.affiliationMassachusetts Gen Hosp, Dept Neurol, ACC 729C,55 Fruit St, Boston, MA 02114 USA
dc.description.affiliationHacettepe Univ Hosp, Dept Neurol, Ankara, Turkey
dc.description.affiliationMassachusetts Gen Hosp, Athinoula A Martinos Ctr Biomed Imaging, Dept Radiol, Charlestown, MA USA
dc.description.affiliationUniv Fed Sao Paulo, Dept Neurol, Sao Paulo, Brazil
dc.description.affiliationUniv Calgary, Dept Clin Neurosci, Calgary, AB, Canada
dc.description.affiliationUniv Calgary, Hotchkiss Brain Inst, Calgary, AB, Canada
dc.description.affiliationUnifespUniv Fed Sao Paulo, Dept Neurol, Sao Paulo, Brazil
dc.description.sourceWeb of Science
dc.format.extent541-547
dc.identifierhttp://dx.doi.org/10.1177/0333102416650706
dc.identifier.citationCephalalgia. London, v. 37, n. 6, p. 541-547, 2017.
dc.identifier.doi10.1177/0333102416650706
dc.identifier.issn0333-1024
dc.identifier.urihttps://repositorio.unifesp.br/handle/11600/54597
dc.identifier.wosWOS:000401026600006
dc.language.isoeng
dc.publisherSage Publications Ltd
dc.relation.ispartofCephalalgia
dc.rightsAcesso restrito
dc.subjectReversible cerebral vasoconstriction syndromeen
dc.subjecttranscranial Doppleren
dc.subjectcerebrovascular reactivityen
dc.subjectbreath-hold challengeen
dc.subjectmigraineen
dc.titleCerebral vasomotor reactivity in reversible cerebral vasoconstriction syndromeen
dc.typeArtigo
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