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Abstract Details

Simultaneous Subarachnoid Hemorrhage and Transient Global Amnesia Secondary to Reversible Cerebral Vasoconstriction Syndrome
Cerebrovascular Disease and Interventional Neurology
P11 - Poster Session 11 (8:00 AM-9:00 AM)
4-020
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A 67 year old female presented to the Gold Coast University Hospital in Queensland, Australia. There was no significant medical history. She had abrupt onset of thunderclap headache, anterograde and retrograde amnesia, vomiting and fecal incontinence after 10 minutes of vigorous exercise. Blood pressure was 142/86. There was no head or neck trauma. Initial clinical evaluation revealed no focal neurological abnormalities. Computed tomography (CT) of the head and CT angiography revealed subtle right frontal hyperdensity consistent with subarachnoid hemorrhage. CT angiography demonstrated peripheral intracranial arterial beading suggestive of reversible cerebral vasoconstriction syndrome (RCVS). Regular nimodipine was commenced. Amnesia and headache both resolved over 24 hours. Magnetic resonance imaging (MRI) brain 24 hours later was abnormal, revealing right frontal subarachnoid hemorrhage and focal diffusion restriction within the right hippocampus. Cerebral vessels on MR angiography were of normal caliber. Nimodipine was continued for a total of 3 months with no further clinical events or ongoing evidence of vasospasm.
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RCVS presenting with thunderclap headache is well described. This case demonstrates simultaneous occurrence of subarachnoid hemorrhage and transient global amnesia as consequences of reversible vasoconstriction. This constellation of findings occurring simultaneously has not previously been described in the context of RCVS.
Authors/Disclosures
Reuben Beer, MBBS
PRESENTER 		Dr. Beer has nothing to disclose.
Peter Bailey, MD No disclosure on file