Scientific article
Case report
OA Policy
English

Reversible cerebral vasoconstriction syndrome during caesarean section

Published inBMJ case reports, vol. 12, no. 12, e230606
Publication date2019-12-05
First online date2019-12-05
Abstract

We describe the case of a 25-year-old parturient who presented sudden onset and short-lived severe headache caused by reversible cerebral vasoconstriction syndrome (RCVS) during an emergency caesarean section. The syndrome was triggered by phenylephrine administered intravenously to correct arterial hypotension following spinal anaesthesia. RCVS is a clinical and radiological syndrome attributed to transient disturbance in the control of cerebral arterial tone resulting in vasospasms. The syndrome can be precipitated by several triggers, including vasoactive drugs, often used during spinal anaesthesia, illicit drugs, pregnancy and postpartum state. Diagnosis and management can be challenging during pregnancy, peripartum or post partum, since many medications commonly used during these periods must be avoided to prevent triggering RCVS. The aim of this report is to raise the awareness, particularly for anaesthesiologists and obstetricians, of this rare and potentially serious syndrome. We discuss diagnosis, triggers, pathogenesis, clinical course and complications, as well as coordinated multidisciplinary management plans.

Keywords
  • Anaesthesia
  • Headache (including migraines)
  • Neurology (drugs and medicines)
  • Obstetrics, gynaecology and fertility
  • Adult
  • Anesthesia, Spinal / adverse effects
  • Cerebrovascular Disorders / chemically induced
  • Cerebrovascular Disorders / complications
  • Cerebrovascular Disorders / diagnosis
  • Cerebrovascular Disorders / diagnostic imaging
  • Cesarean Section
  • Diagnosis, Differential
  • Female
  • Headache / etiology
  • Humans
  • Hypertension / chemically induced
  • Hypertension / complications
  • Hypertension / diagnosis
  • Hypertension / diagnostic imaging
  • Intraoperative Complications / chemically induced
  • Intraoperative Complications / diagnosis
  • Phenylephrine / administration & dosage
  • Phenylephrine / adverse effects
  • Precipitating Factors
  • Pregnancy
  • Vasoconstrictor Agents / administration & dosage
  • Vasoconstrictor Agents / adverse effects
  • Vasospasm, Intracranial / chemically induced
  • Vasospasm, Intracranial / complications
  • Vasospasm, Intracranial / diagnosis
  • Vasospasm, Intracranial / diagnostic imaging
Citation (ISO format)
SAFRAN, Szilard Laszlo, BALMER, Christian, SAVOLDELLI, Georges Louis. Reversible cerebral vasoconstriction syndrome during caesarean section. In: BMJ case reports, 2019, vol. 12, n° 12, p. e230606. doi: 10.1136/bcr-2019-230606
Main files (1)
Article (Published version)
accessLevelPublic
Identifiers
Journal ISSN1757-790X
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95downloads

Technical informations

Creation09/10/2024 15:45:59
First validation15/01/2025 09:57:07
Update15/01/2025 09:57:07
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