Abstract Details

Title An Epidemiological Analysis of Reversible Cerebral Vasoconstriction Syndrome: A Nationwide Database Study

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P11 - Poster Session 11 (5:30 PM-6:30 PM)

Poster/Presentation
Number 5-026

Objective To describe the demographics, risk factors, and clinical manifestations of patients diagnosed with Reversible Cerebral Vasoconstriction Syndrome (RCVS).

Background RCVS is a condition characterized by multifocal constriction of cerebral arteries that presents with a wide array of clinical manifestations often with unknown etiology. Although the literature is growing, its incidence, risk factors, and manifestations are still not well established.

Design/Methods Through the PearlDiver Mariner database, RCVS patients were identified using ICD-10 codes. Along with patient demographics, the incidence of risk factors including current pregnancy, recent pregnancy within 6 weeks, history of migraine, presence of unruptured cerebral aneurysms, use of vasoconstrictive drugs (triptans, selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), ergot derivatives) and recent cannabis use were analyzed. The incidence of clinical manifestations such as ischemic stroke, intracranial hemorrhage, transient ischemic attack (TIA), focal neurological deficits (hemiplegia, aphasia, visual deficits, ataxia), and seizure were also described.

Results Our population had an average age of 56.4 with a female preponderance at 69.2%. 19.9% of the population had a history of migraine, but the incidences of current or recent pregnancy (0% and 0.2%), and history of unruptured aneurysm (4.3%) were markedly lower. 9.1% of patients had used an SSRI within 45 days and 3.6% had used an SNRI, but only 1.82% had used cannabis within 3 months of presentation. The most common clinical manifestation was TIA at 22.9%, followed by ischemic stroke (13.8%) and intracerebral hemorrhage (12.7%).

Conclusions Given the heterogeneity of presenting features of RCVS, a high degree of clinical suspicion is required to avoid delaying care for patients. There was no risk factor identified that could account for the majority of RCVS cases in this population despite our analysis of “classic” causes like SSRI use and pregnancy, reflecting the need for further investigation into the etiology of this mysterious syndrome.

Authors/Disclosures
Pranav Mirpuri, MD PRESENTER	Mr. Mirpuri has nothing to disclose.
Syed Khalid	No disclosure on file
Mariyam Humayun, MD	Dr. Humayun has nothing to disclose.
Faten El Ammar, MD (University of IL, Chicago)	Dr. El Ammar has nothing to disclose.
Jared Davis (University of Illinois, Chicago)	No disclosure on file
Gursant Atwal (UIC)	Gursant Atwal has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Aesculap.
Ciro Ramos Estebanez, MD, PhD, MBA, FAAN (University of Illinois in Chicago)	The institution of Dr. Ramos Estebanez has received research support from NIH. Dr. Ramos Estebanez has received intellectual property interests from a discovery or technology relating to health care.

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