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. 2017 Dec;18(1):29.
doi: 10.1186/s10194-017-0738-x. Epub 2017 Feb 23.

Cerebral endothelial dysfunction in reversible cerebral vasoconstriction syndrome: a case-control study

Hyun Ah Choi  1 , Mi Ji Lee  1 , Chin-Sang Chung  2
Affiliations

Cerebral endothelial dysfunction in reversible cerebral vasoconstriction syndrome: a case-control study

Hyun Ah Choi et al. J Headache Pain. 2017 Dec.

Abstract

Background: The aim of this study is to investigate cerebral endothelial dysfunction in patients with reversible cerebral vasoconstriction syndrome (RCVS).

Methods: We prospectively recruited patients with RCVS, age-matched controls with episodic migraine, and age-matched healthy controls at Samsung Medical Center from Apr 2015 to Jul 2016. All participants underwent transcranial Doppler evaluation, with a breath-holding maneuver, for the evaluation of bilateral middle cerebral arteries (MCAs), posterior cerebral arteries (PCAs), and the basilar artery (BA). The breath-holding index (BHI) was used to measure cerebral endothelium-dependent vasodilation. Follow-up BHIs were recorded in selected patients with RCVS after 3 months.

Results: A total of 84 subjects were recruited for this study (n = 28 in each group of RCVS, episodic migraine, and healthy control; mean age, 49.8 years). The RCVS group showed lower BHIs in all basal arteries, in comparison to healthy controls (p < 0.001, 0.009 for bilateral MCAs, p < 0.001 and 0.028 for bilateral PCAs, and p = 0.060 for the BA). Compared to migraineurs, RCVS patients had lower BHIs only in the anterior circulation (p = 0.002 and 0.038 for bilateral MCAs; p = 0.069 and 0.247 for bilateral PCAs; p = 0.120 for the BA). Of the 10 patients who had follow-up BHIs at 3 months, 7 showed complete normalization, while three did not.

Conclusions: Cerebral endothelial function is impaired in a widespread distribution in RCVS. Its role in the pathogenesis and clinical outcome of RCVS should be determined in further studies.

Keywords: Breath holding index; Cerebral vasomotor reactivity; Endothelial dysfunction; Pathophysiology; Reversible cerebral vasoconstriction syndrome.

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Figures

Fig. 1
Fig. 1
Baseline and follow-up breath holding indices in patients and matched controls Breath holding index (BHI) of all tested vessels was averaged. The follow-up study showed a complete normalization in seven patients, no change in two, and aggravation in one patient
See this image and copyright information in PMC

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