Abstract Details

Title Factors Associated with Poor Outcomes in Reversible Cerebral Vasoconstriction Syndrome: A Seven-year Study at a Comprehensive Stroke Center

Topic General Neurology

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

Poster/Presentation
Number 4-005

Objective To investigate the clinical and demographic factors associated with poor outcomes in reversible cerebral vasoconstriction syndrome (RCVS).

Background Although most cases of RCVS result in favorable outcomes, occasional severe neurological deficits, strokes, or fatalities have been reported. However, patients with RCVS and poor outcomes have not been well characterized across studies.

Design/Methods This descriptive study included adults (≥18 years) admitted to a comprehensive stroke center from 2016 to 2023 with an index diagnosis of RCVS. Patients who experienced serious complications including subarachnoid hemorrhage (SAH), intracerebral hemorrhage (ICH), ischemic stroke (IS), reversible cerebral edema, seizure, or death, were univariately compared to those who did not experience any. Outcomes included discharge disposition (home/home health vs. other) and hospital length of stay (days), with continuous data presented as median (interquartile range).

Results The study included 35 RCVS patients with a median age of 44 (30-53) years; 74% were women, and they spent a median of 4 (3-10) days in the hospital. More than half (57%) of the patients had at least one additional neurological diagnosis: SAH (34%), IS (29%), seizure (9%), ICH (9%), reversible brain edema (9%), or death (5%). Overall, 80% of patients were discharged home. Complications were more common in female patients (90% vs. 10%, p=0.02) and correlated with more days on verapamil treatment (5 (3-11) vs. 2 (1-2), p=0.005) compared to those without complications. Patients experiencing complications also had longer hospital stays (9 (4-14) vs. 3 (1-3), p=0.005) and a lower rate of home discharge (65% vs. 100%, p=0.01). Although more patients with complications received steroids (30% vs. 7%), this difference did not reach statistical significance.

Conclusions Despite most patients being discharged home, further research is warranted to investigate the higher prevalence of RCVS diagnosis in women and the underlying factors contributing to increased complications among female patients.

Authors/Disclosures
John P. Peralta, DO PRESENTER	Dr. Peralta has nothing to disclose.
Constance McGraw	No disclosure on file
Yasaman Pirahanchi, MD (Brigham and Women's Hospital)	Dr. Pirahanchi has nothing to disclose.
Christian J. Burrell, MD (Blue Sky Neurology)	Dr. Burrell has nothing to disclose.
Amy Nieberlein	No disclosure on file
David Bar-Or	David Bar-Or has received intellectual property interests from a discovery or technology relating to health care.
Russell E. Bartt, MD, FAAN (Blue Sky Neurosciences)	Dr. Bartt has nothing to disclose.

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