The usefulness of transcranial color flow imaging for evaluating the changes of vasoconstriction in reversible cerebral vasoconstriction syndrome

Abstract

A 37-year-old Japanese woman, whose pregnancy course was good, was taken to our hospital in child birthing. She complained severe headache and paralysis at the left side of limbs and head CT revealed intracranial hemorrhage in the right basal ganglia. On the day 14, head MRI showed various regions of vasoconstriction which means reversible cerebral vasoconstriction syndrome (RCVS), and transcranial color flow imaging (TC-CFI) showed highest peak systolic flow velocity (PSV) of middle cerebral artery (MCA: 317 cm/s). As vasoconstriction on MRA became decline without additional neurological deficiency, TC-CFI also showed the decline of the PSV of MCA. We evaluated transitions of images of MRI and TC-CFI, and thought that they linked with each other. We believe that TC-CFI is a non-invasive, repeatable, and useful tool to evaluate the changes of vasoconstriction to follow RCVS.