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dc.contributor.authorMuehlschlegel, Susanne
dc.contributor.authorKursun, Oguzhan
dc.contributor.authorTopcuoglu, Mehmet A.
dc.contributor.authorFok, Joshua
dc.contributor.authorSinghal, Aneesh B.
dc.date2022-08-11T08:08:33.000
dc.date.accessioned2022-08-23T15:58:43Z
dc.date.available2022-08-23T15:58:43Z
dc.date.issued2013-10-01
dc.date.submitted2015-10-08
dc.identifier.citationMuehlschlegel 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.issn2168-6149 (Linking)
dc.identifier.doi10.1001/jamaneurol.2013.3484
dc.identifier.pmid23939614
dc.identifier.urihttp://hdl.handle.net/20.500.14038/30499
dc.description.abstractIMPORTANCE: 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.isoen_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.rightsCopyright American Medical Association. Publisher PDF posted as allowed by the publisher's author rights policy at http://archneur.jamanetwork.com/public/instructionsForAuthors.aspx.
dc.subjectAdult
dc.subjectAged
dc.subjectCerebral Angiography
dc.subjectCohort Studies
dc.subjectDiagnosis, Differential
dc.subjectFemale
dc.subjectHumans
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectMultivariate Analysis
dc.subjectPredictive Value of Tests
dc.subjectSubarachnoid Hemorrhage
dc.subjectTomography Scanners, X-Ray Computed
dc.subjectVasospasm, Intracranial
dc.subjectNervous System Diseases
dc.subjectNeurology
dc.titleDifferentiating reversible cerebral vasoconstriction syndrome with subarachnoid hemorrhage from other causes of subarachnoid hemorrhage
dc.typeJournal Article
dc.source.journaltitleJAMA neurology
dc.source.volume70
dc.source.issue10
dc.identifier.legacyfulltexthttps://escholarship.umassmed.edu/cgi/viewcontent.cgi?article=1776&amp;context=faculty_pubs&amp;unstamped=1
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/faculty_pubs/775
dc.identifier.contextkey7693426
refterms.dateFOA2022-08-23T15:58:43Z
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.submissionpathfaculty_pubs/775
dc.contributor.departmentDepartment of Neurology
dc.source.pages1254-60


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