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Reversible cerebral vasoconstriction syndrome combined with posterior reversible encephalopathy syndrome after heart transplantation
Institution:1. Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam, Republic of Korea;2. Department of Neurosurgery, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea;1. Department of Neurology, Ulsan University Medical School, Ulsan University Hospital, Ulsan, Republic of Korea;2. Department of BioNano Technology and Gachon Medical Research Institute, Gachon University, Sungnam, Republic of Korea;3. Department of Neurology, Chung-Ang University College of Medicine, Seoul, Republic of Korea;4. Department of Neurology, Seoul National University College of Medicine and Neurocognitive Behavior Center, Seoul National University Bundang Hospital, Sungnam, Republic of Korea;1. Department of Surgery, Amai Pakpak Medical Center, Philippines;2. Department of Surgery, Seoul National University Bundang Hospital, Republic of Korea;3. Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Republic of Korea;1. Department of Emergency Medicine, Seoul National University Bundang Hospital, Seong-nam, Korea;2. Department of Emergency Medicine, Seoul National University Hospital, Seoul, Korea;3. Department of Pathology, GC Labs, Youngin, Korea
Abstract:Reversible cerebral vasoconstriction syndrome (RCVS) combined with posterior reversible encephalopathy syndrome (PRES) is a rare complication in patients treated with immunosuppressants. A 52-year-old male patient presented with seizures after heart transplantation. The patient was suspected of having PRES on brain images. Despite the strict blood pressure control, the patient presented with altered mentality and the brain images showed a newly developed large acute infarction. Digital subtraction angiography (DSA) revealed the classic “sausage on a string” appearance of the cerebral arteries – potential feature of RCVS. To our knowledge, this is the first case report to describe RCVS combined with PRES after heart transplantation.
Keywords:Reversible cerebral vasoconstriction syndrome  Posterior reversible encephalopathy syndrome  Vasoconstriction  Cerebral infarction  Immunosuppressant
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