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Reversible Cerebral Vasoconstriction Syndrome (RCVS) is a syndrome described at the end of the 20th century. Generally, it has a benign course. It is revealed by acute headaches, in different circumstances such as sexual activity, physical exertion or emotional disturbances. But, in few cases, it might be complicated by seizure, stroke and subarachnoid haemorrhage. The diagnosis is confirmed on radiological examination, which shows diffuse cerebral vasoconstriction of brain vessel. It calls reversible because at three month, vasoconstriction disappears. Most cases occur during post partum or after serotoninergic/adrenergic drug use. The pathophysiology is unknown but a transient disturbance in the control of cerebrovascular tone by sympathic hyperactivity and/or endothelial dysfunction are suspected. The assessment of endothelial dysfunction in brain is possible with transcranial doppler. Chen et al. showed an impairment of vasodilatation post apnea induced called BHI on RCVS subjects compared with healthy control. BHI is a reflect of endothelial function in brain. Currently, investigators do not know if endothelial dysfunction occurred only in brain or if it may occur in systemic vessel. Some case reports talk about systemic complication such as kidney infarct or hepatic arterial vasospasm so a systemic vascular dysfunction may be suspected. In this study, researchers will study systemic endothelial function by measure of the pulse wave velocity during RCVS and after its recovering at 3 months, and compare it at healthy controls.
The investigators lead a case control study to find a systemic endothelial dysfunction by the using of Complior device. Complior is a mechanographer who calculates pulse wave velocity (PWV). Pulse wave velocity is a reflect of arterial stiffness and it's correlate with endothelial dysfunction. For BHI, a Philips echograph is used before and after 30 second of breath holding.
Study protocol is :
For Patient :
For control :
- Day 0 : in hospital : medical history, physic examination, EKG, BHI, PWV analysis
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Patient | Diagnosis of probable SVCR evoked, faced with a single or repeated episode of unusual thunderclap or rapidly progressive headache, and demonstration of diffuse vasospasms via sectional imaging (angiography, angio-MRI or cerebral arteriography) or an increase in transcranial doppler speeds | ||
| Subject control | Subject without SVCR (current and history) |
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| Measure | Description | Time Frame |
|---|---|---|
| Compare systemic endothelial function between patient and healthy subject | By using Complior, researchers assess systemic endothelial function at inclusion on patient and healthy volunteer person by pulse wave velocity (cm.s-1) | 24 hours |
| Measure | Description | Time Frame |
|---|---|---|
| BHI (Breath Holding Index) | BHI measure on middle cerebral arteries by transcranial ultrasound | at day 0, month 1, month 3 |
| Pulse wave velocity (PWV) | Pulse wave velocity mesaure from carotid to femoral artery |
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Inclusion Criteria for patients :
Inclusion criteria for control :
Exclusion Criteria:
Non inclusion criteria for patient :
Exclusion criteria for patient :
- No reversibility at 3 months
Non inclusion criteria for control :
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Patients and Healthy subjects
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Nantes University Hospital | Nantes | Loire-Atlantique | 44093 | France |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 41589411 | Derived | Constant Dit Beaufils P, Barbin L, Pere M, Colleu C, Connault J, Preterre C, Guillon B, de Gaalon S. Systemic Arterial Stiffness in Reversible Cerebral Vasoconstriction Syndrome: A Prospective Case-Control Study. Eur J Neurol. 2026 Feb;33(2):e70495. doi: 10.1111/ene.70495. |
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| at day 0, month 1, month 3 |
| Relationship between cerebral and systemic endothelial function | Comparison of BHI and VOP evolution | at day 0, month 1, month 3 |
| Renal failure | Diminution of creatinin clearance<100 ml/min/1.73m2 | Day 0 |
| Occurence of stroke or cerebral oedema | Occurrence of ischemic stroke, cerebral haemorrhage, cerebral oedema | at day 0, month 1, month 3 |
| Comparison of PWV between patients with or without arterial hypertension | Comparison between middle PWV (cm/s) of patients with arterial hypertension and patients without arterial hypertension | at day 0, month 1, month 3 |
| Comparison of BHI between patients with or without arterial hypertension | Comparison between middle BHI of patients with arterial hypertension and patients without arterial hypertension | at day 0, month 1, month 3 |
| Comparison between PWV (cm/s) | Comparison between PWV (cm/s) between patients and control group | at 3 months |
| Comparison between BHI (cm/s) | Comparison between BHI (cm/s) between patients and control group | at 3 months |