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. 2023 Jul;270(7):3584-3594.
doi: 10.1007/s00415-023-11708-z. Epub 2023 Apr 13.

Complications of reversible cerebral vasoconstriction syndrome in relation to age

Kristin Sophie Lange  1   2   3 , Gabrielle Tuloup  4   5 , Claire Duflos  6 , Claire Gobron  7 , Cécilia Burcin  4 , Lucas Corti  8 , Caroline Roos  4 , Anne Ducros #  8   9 , Jérôme Mawet #  4
Affiliations

Complications of reversible cerebral vasoconstriction syndrome in relation to age

Kristin Sophie Lange et al. J Neurol. 2023 Jul.

Abstract

Introduction: Reversible cerebral vasoconstriction syndrome (RCVS) has a heterogenous clinical and radiological presentation. We investigated whether RCVS complications vary according to age.

Patients and methods: In a pooled French cohort of 345 patients with RCVS, we assessed (1) rates of clinical and radiological complications, and (2) the functional outcome at 3 months according to age as a continuous variable, and in young patients aged ≤ 49 years versus those aged ≥ 50 years. The Commission Nationale Informatique et Liberté and the local ethics committee approved this study (registration number: 202100733).

Results: The risk for any focal deficit and for any brain lesion were independently associated with increasing age (OR 1.4, 95% CI 1.1-1.8; p = 0.014, and OR 1.6, 95% CI 1.2-2.1; p < 0.001, respectively). Subtypes of brain lesions independently associated with increasing age were subarachnoid haemorrhage (OR 1.7, 95% CI 1.3-2.3; p < 0.001) and intracerebral haemorrhage (OR 1.5, 95% CI 1.1-2.2; p = 0.023). Frequency of cervical artery dissections peaked at age 30-39, and young age was independently associated with cervical artery dissections (OR 13.6, 95% CI 2.4-76.6; p = 0.003). Age had no impact on the functional outcome, with a modified Rankin scale score of 0-1 in > 96% of patients.

Conclusion: Age seems to influence rates and types of complications of RCVS, with young age being associated with cervical artery dissections, and increasing age with haemorrhagic complications. If confirmed in larger prospective studies, recognition of age-specific patterns might help to guide clinical management and to identify complications in cases of RCVS and vice versa.

Keywords: Cerebrovascular diseases; Intracerebral haemorrhage; Reversible cerebral vasoconstriction syndrome; Stroke; Subarachnoid haemorrhage; Thunderclap headache.

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Conflict of interest statement

KSL received travel and accommodation expenses from Acticor Biotech and Teva, not related to the submitted work. CR received honoraria for board membership and speaker fees Allergan/Abbvie, Homeperf, Lilly, Lundbeck, Mylan, Novartis, Ophtalmic, Orkyn, Pfizer, Sanofi and Teva, and travel, accommodation, and meeting expenses from Teva, Lundbeck and Lilly, all outside the submitted work. AD received honoraria for board membership and speaker fees from Allergan Abbvie, Lilly, Teva, Lundbeck, Pfizer and travel, accommodation, and meeting expenses from Teva, and SOS Oxygène, all outside the submitted work; she is associate editor of Cephalalgia. JM received travel, accommodation, and meeting expenses from SOS, GEP Sante, Lundbeck and Homeperf and received honoraria for advisory boards or speaker fees from Abbvie, Teva, Lilly, Lundbeck and Novartis not related to the submitted work; he is a member of the redaction committee of “La Lettre du Neurologue” without financial compensation. The other authors report no conflicts of interest.

Figures

Fig. 1
Fig. 1
a–d Rates of clinical complications in RCVS according to age groups. Clinical complications are shown in percentages for each age group. n number; yrs years
Fig. 2
Fig. 2
a–f Rates of radiological complications in RCVS according to age groups. Radiological complications are shown in percentages for each age group. n number; PRES posterior reversible encephalopathy syndrome; yrs years
See this image and copyright information in PMC

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