2026 Volume 48 Issue 3 Pages 126-133
A 48-year-old woman developed headache and severe visual disturbance upon waking up. On arrival at our hospital, the patient was completely blind and had mild left-lower-limb paralysis. Diffusion-weighted brain magnetic resonance imaging revealed high-signal-intensity lesions in the bilateral occipital lobes, and a FLAIR high ventral pontine lesion was observed. Brain MRA revealed spasms in all cerebral arteries. We suspected reversible cerebral vasoconstriction syndrome and stroke, so the patient was treated with edaravone, lomerizine, and aspirin. Then, we treated the patient for Basedow’s disease. Brain imaging indicated worsening until the fifth day of illness but gradual improvement along with her neurological symptoms. On day 35 of hospitalization, her left-sided paralysis healed, and her vision returned to the manual valve level. Five months after onset, her visual acuity was 0.3, and she was able to perform independently at home. Basedow’s disease may induce spasms in the cerebral arteries.
