Differentiating reversible cerebral vasoconstriction syndrome with subarachnoid hemorrhage from other causes of subarachnoid hemorrhage
dc.contributor.author | Muehlschlegel, Susanne | |
dc.contributor.author | Kursun, Oguzhan | |
dc.contributor.author | Topcuoglu, Mehmet A. | |
dc.contributor.author | Fok, Joshua | |
dc.contributor.author | Singhal, Aneesh B. | |
dc.date | 2022-08-11T08:08:33.000 | |
dc.date.accessioned | 2022-08-23T15:58:43Z | |
dc.date.available | 2022-08-23T15:58:43Z | |
dc.date.issued | 2013-10-01 | |
dc.date.submitted | 2015-10-08 | |
dc.identifier.citation | Muehlschlegel S, Kursun O, Topcuoglu MA, Fok J, Singhal AB. Differentiating reversible cerebral vasoconstriction syndrome with subarachnoid hemorrhage from other causes of subarachnoid hemorrhage. JAMA Neurol. 2013 Oct;70(10):1254-60. PubMed PMID: 23939614. <a href="http://dx.doi.org/10.1001/jamaneurol.2013.3484">Link to article on publisher's site</a> | |
dc.identifier.issn | 2168-6149 (Linking) | |
dc.identifier.doi | 10.1001/jamaneurol.2013.3484 | |
dc.identifier.pmid | 23939614 | |
dc.identifier.uri | http://hdl.handle.net/20.500.14038/30499 | |
dc.description.abstract | IMPORTANCE: Reversible cerebral vasoconstriction syndrome (RCVS) is a clinical-angiographic syndrome characterized by recurrent thunderclap headaches and reversible segmental multifocal cerebral artery narrowing. More than 30% of patients with RCVS develop subarachnoid hemorrhage (SAH). Patients with RCVS with SAH (RCVS-SAH) are often misdiagnosed as having potentially ominous conditions such as aneurysmal SAH (aSAH) or cryptogenic "angiogram-negative" SAH (cSAH) owing to overlapping clinical and imaging features. OBJECTIVE: To identify predictors that can distinguish RCVS-SAH from aSAH and cSAH at the time of clinical presentation. DESIGN: Retrospective analysis of 3 patient cohorts: patients with RCVS (1998-2009), patients with aSAH (1995-2003), and patients with cSAH (1995-2003). SETTING: Academic hospital and tertiary referral center. PARTICIPANTS: Consecutive patients with RCVS-SAH (n = 38), aSAH (n = 515), or cSAH (n = 93) whose conditions were diagnosed using standard criteria. MAIN OUTCOMES AND MEASURES: Multivariate logistic regression analysis was used to identify predictors that differentiate RCVS-SAH from aSAH and cSAH. RESULTS: Predictors differentiating RCVS-SAH from aSAH were younger age, chronic headache disorder, prior depression, prior chronic obstructive pulmonary disease, lower Hunt-Hess grade, lower Fisher SAH group, higher number of affected arteries, and the presence of bilateral arterial narrowing. Predictors differentiating RCVS-SAH from cSAH were younger age, female sex, prior hypertension, chronic headache disorder, lower Hunt-Hess grade, lower Fisher SAH group, and the presence of bilateral arterial narrowing. CONCLUSIONS AND RELEVANCE: We identified important clinical and imaging differences between RCVS-SAH, aSAH, and cSAH that may be useful for improving diagnostic accuracy, clinical management, and resource utilization. | |
dc.language.iso | en_US | |
dc.relation | <a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=23939614&dopt=Abstract">Link to Article in PubMed</a> | |
dc.rights | Copyright American Medical Association. Publisher PDF posted as allowed by the publisher's author rights policy at http://archneur.jamanetwork.com/public/instructionsForAuthors.aspx. | |
dc.subject | Adult | |
dc.subject | Aged | |
dc.subject | Cerebral Angiography | |
dc.subject | Cohort Studies | |
dc.subject | Diagnosis, Differential | |
dc.subject | Female | |
dc.subject | Humans | |
dc.subject | Male | |
dc.subject | Middle Aged | |
dc.subject | Multivariate Analysis | |
dc.subject | Predictive Value of Tests | |
dc.subject | Subarachnoid Hemorrhage | |
dc.subject | Tomography Scanners, X-Ray Computed | |
dc.subject | Vasospasm, Intracranial | |
dc.subject | Nervous System Diseases | |
dc.subject | Neurology | |
dc.title | Differentiating reversible cerebral vasoconstriction syndrome with subarachnoid hemorrhage from other causes of subarachnoid hemorrhage | |
dc.type | Journal Article | |
dc.source.journaltitle | JAMA neurology | |
dc.source.volume | 70 | |
dc.source.issue | 10 | |
dc.identifier.legacyfulltext | https://escholarship.umassmed.edu/cgi/viewcontent.cgi?article=1776&context=faculty_pubs&unstamped=1 | |
dc.identifier.legacycoverpage | https://escholarship.umassmed.edu/faculty_pubs/775 | |
dc.identifier.contextkey | 7693426 | |
refterms.dateFOA | 2022-08-23T15:58:43Z | |
html.description.abstract | <p>IMPORTANCE: Reversible cerebral vasoconstriction syndrome (RCVS) is a clinical-angiographic syndrome characterized by recurrent thunderclap headaches and reversible segmental multifocal cerebral artery narrowing. More than 30% of patients with RCVS develop subarachnoid hemorrhage (SAH). Patients with RCVS with SAH (RCVS-SAH) are often misdiagnosed as having potentially ominous conditions such as aneurysmal SAH (aSAH) or cryptogenic "angiogram-negative" SAH (cSAH) owing to overlapping clinical and imaging features.</p> <p>OBJECTIVE: To identify predictors that can distinguish RCVS-SAH from aSAH and cSAH at the time of clinical presentation.</p> <p>DESIGN: Retrospective analysis of 3 patient cohorts: patients with RCVS (1998-2009), patients with aSAH (1995-2003), and patients with cSAH (1995-2003).</p> <p>SETTING: Academic hospital and tertiary referral center.</p> <p>PARTICIPANTS: Consecutive patients with RCVS-SAH (n = 38), aSAH (n = 515), or cSAH (n = 93) whose conditions were diagnosed using standard criteria.</p> <p>MAIN OUTCOMES AND MEASURES: Multivariate logistic regression analysis was used to identify predictors that differentiate RCVS-SAH from aSAH and cSAH.</p> <p>RESULTS: Predictors differentiating RCVS-SAH from aSAH were younger age, chronic headache disorder, prior depression, prior chronic obstructive pulmonary disease, lower Hunt-Hess grade, lower Fisher SAH group, higher number of affected arteries, and the presence of bilateral arterial narrowing. Predictors differentiating RCVS-SAH from cSAH were younger age, female sex, prior hypertension, chronic headache disorder, lower Hunt-Hess grade, lower Fisher SAH group, and the presence of bilateral arterial narrowing.</p> <p>CONCLUSIONS AND RELEVANCE: We identified important clinical and imaging differences between RCVS-SAH, aSAH, and cSAH that may be useful for improving diagnostic accuracy, clinical management, and resource utilization.</p> | |
dc.identifier.submissionpath | faculty_pubs/775 | |
dc.contributor.department | Department of Neurology | |
dc.source.pages | 1254-60 |