[Clinical and imaging features of diffuse cerebral vasoconstriction].

PURPOSE: To report clinical and imaging features of diffuse cerebral vasoconstriction and to discuss the role of non-invasive imaging modalities for the diagnosis and the follow-up.

PATIENTS AND METHODS: Retrospective study including 13 consecutive patients with a diffuse cerebral vasoconstriction. Evaluation of the sensitivity of Doppler US and magnetic resonance angiography for the diagnosis.

RESULTS: The diagnosis is based on the association of a thunderclap headache, declenching factors found in 50% of cases and of stenosis involving middle and small cerebra arteries. In some cases cerebral hemorrhage may be present.

DISCUSSION: Diffuse cerebral vasoconstriction is a rare cause of thunder clap headhache, which needs to exclude other causes such as subarchnoid hemorrhage from aneurysm rupture. Non contrast CT of the head, frequently normal, may be falsely reassuring. It is therefore necessary to further assess the cerebral arteries to exclude an aneurysm but also to detect the presence of stenoses that would suggest the diagnosis. Non-invasive imaging modalities (MRA and Doppler US) are favored for detection and follow-up of proximal lesions.