Reversible vasoconstriction syndrome involving the basilar artery in an adolescent: imaging and clinical features

Abstract

Importance: Reversible cerebral vasoconstriction syndrome is characterized by recurrent episodes of "thunderclap headache" and by transient, multifocal vasoconstriction of cerebral vasculature. Here we present an adolescent boy whose clinical features fit the diagnostic criteria and whose neurovascular imaging revealed reversible vasoconstriction of the basilar artery alone.

Observation: A previously healthy 14-year-old boy presented with repeated severe sudden thunderclap headaches following exercise. These symptoms were accompanied by isolated basilar artery stenosis.

Conclusion: Reversible cerebral vasoconstriction syndrome is a condition with several clinical triggers. Its pathophysiology is poorly understood. This patient adds to a broadening spectrum of clinical features of this disorder.

Keywords: adolescent; basilar artery; reversible cerebral vasoconstriction syndrome; thunderclap headache.