Reversible Cerebral Vasoconstriction Syndrome Associated with Ileostomy and Blood Transfusion in a Patient with Advanced Gastric Cancer: A Case Report and Review of the Literature

초록

Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by transient multifocal segmental arterial narrowing, and it is often accompanied by thunderclap headaches. However, RCVS may mimic an ischemic stroke in atypical cases without thunderclap headaches. Vasoactive drugs and pregnancy are the most well-known precipitating factors for RCVS, but recent reports have described cases associated with blood transfusion or malignancy. We report the case of a patient with advanced gastric cancer, who developed multiple acute cerebral infarctions and arterial narrowing after emergency ileostomy and blood transfusion. Cerebral angiography showed improvement after intra-arterial nimodipine infusion, confirming the diagnosis of RCVS.

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