Pediatric Reversible Cerebral Vasoconstriction Syndrome: Two Unique Cases with a Review of all Reported Children

Abstract

Reversible cerebral vasoconstriction syndrome (RCVS) has been well described in adults, but pediatric cases are yet under recognized. We described two children with RCVS and review similar already published pediatric cases. The first patient was a 10-year-old girl who presented with severe headaches and seizures 3 days after blood transfusion. Brain magnetic resonance imaging (MRI) showed changes compatible with posterior reversible encephalopathy syndrome and subarachnoid hemorrhage. Magnetic resonance angiogram showed diffuse vasoconstriction of multiple cerebral arteries. The second patient was a 9-year-old male child who presented with severe thunderclap headaches. Brain MRI showed isolated intraventricular hemorrhage. Computed tomography/MR angiogram and digital subtraction angiogram were normal. A week later, he developed focal neurological deficits. Repeated MR angiogram showed diffuse vasospasm of multiple intracranial arteries. Both children recovered completely. A clinico-radiological review of previously reported childhood RCVS is provided.

Keywords

reversible cerebral vasoconstriction syndrome - subarachnoid hemorrhage - blood transfusion - intraventricular hemorrhage - posterior reversible encephalopathy - children

Authors' Contributions

N.D. contributed cases; helped in design, data collection, and analysis; critically reviewed the initial manuscript; and revised the final manuscript. R.B. designed the data collection instruments, collected the data, performed the initial analysis, and wrote the first draft. N.S. managed the patient, collected all data, helped in analysis, and wrote the initial draft. V.U. conceptualized and designed the study, coordinated and supervised data collection critically, and revised the final manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Publication History

Received: 05 November 2020

Accepted: 26 December 2020

Article published online:
11 February 2021

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