2025 Clinician Corner - Spinal cord reversible cerebral vasoconstriction syndrome

Abstract 

We present the case of a 19-year-old woman who developed reversible cerebral vasoconstriction syndrome (RCVS) with primarily posterior circulation infarcts, including a high cervical spinal cord infarct. RCVS is thought to be a transient vasospastic condition of the brain and to our knowledge has not been previously described to affect the spinal cord.   

Keywords:  Reversible cerebral vasoconstriction syndrome; RCVS; spinal cord infarction; stroke

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Faculty credentials/disclosure 

The planners and faculty for this activity have no relevant financial relationships to disclose. The patient consented to the publication of this report.

Process

Click the "add to cart/begin" button, pay any relevant fee, take the quiz, complete the evaluation, and claim your CME credit.  You must achieve 100% on the quiz with unlimited attempts available.

  • By completing this process, you are attesting that you have read the journal article.

Expiration date:

Credit eligibility for this article is set to expire on September 1, 2026.

Learning Objectives

After completing the article, the learner should be able to:

  • Recognize thunder clap headache as an acute neurological emergency with many causes, of which reversible cerebral vasoconstriction syndrome (RCVS) is being found increasingly.
  • Complete a proper evaluation for RCVS, which includes neurovascular imaging in conjunction with history corroboration.
  • Identify situations that lend themselves to altered neurovascular autonomic function -- such as use of stimulants, perpeurium, migraines, and anxiety -- to prompt considerations for RCVS.
  • Recognize that the beading appearance on angiogram, which although classically attributed to vasculitis, can also be seen with atherosclerosis and RCVS.

Key Points 

  • Acute atraumatic quadriparesis in a young woman has classically been most concerning for demyelinating disease of the central nervous system, but workup should include an evaluation for strokes and acute neuropathies as well.
  • The history of stimulant use may help guide the workup to include autonomic sensitive systems including cerebral vasculature disease.

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Course summary
Available credit: 
  • 1.00 American Board of Internal Medicine (ABIM) MOC Part 2
    Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.00 MOC points in the American Board of Medicine’s (ABIM) Maintenance of Certification (MOC) program. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.
  • 1.00 American Board of Surgery (ABS) Accredited CME
    Successful completion of this CME activity enables the learner to earn credit toward the CME requirement of the American Board of Surgery’s Continuous Certification program. It is the CME activity provider's responsibility to submit learner completion information to ACCME for the purpose of granting ABS credit.
  • 1.00 AMA PRA Category 1 Credit™
    The A. Webb Roberts Center for Continuing Medical Education of Baylor Scott & White Health is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
  • 1.00 Attendance
Course opens: 
09/01/2025
Course expires: 
09/01/2026
Cost:
$25.00
Rating: 
0
  • Hibba Erum Arif, MBBS - Division of Neurology, Baylor University Medical Center, Dallas, Texas, USA
  • Aisha Masoom, MBBS - Division of Neurology, Baylor University Medical Center, Dallas, Texas, USA
  • Abdul Rub Hakim Mohammed, MD - Division of Emergency Medicine, Baylor University Medical Center, Dallas, Texas USA
  • Idrees Mogri, MDc - Division of Pulmonology and Critical Care Medicine, Baylor University Medical Center, Dallas, Texas, USA
  • Ike Thacker, MD - Department of Radiology, Baylor University Medical Center, Dallas, Texas, USA
  • Sadat Shamim, MD - Division of Neurology, Baylor University Medical Center, Dallas, Texas, USA

Corresponding author: Sadat Shamim, MD, 3417 Gaston Avenue, Ste. 935, Dallas, TX 75246 (e-mail: [email protected]) ORCID Sadat Shamim iD http://orcid.org/0009-0004-4091-6969

Accreditation

The A. Webb Roberts Center for Continuing Medical Education of Baylor Scott & White Health is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Designation

AMA PRA Category 1 Credit™

The A. Webb Roberts Center for Continuing Medical Education of Baylor Scott & White Health designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

ABS CC

Successful completion of this CME activity enables the learner to earn credit toward the CME requirement of the American Board of Surgery’s Continuous Certification program. It is the CME activity provider's responsibility to submit learner completion information to ACCME for the purpose of granting ABS credit.

ABIM MOC

 Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.0 MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

 

Available Credit

  • 1.00 American Board of Internal Medicine (ABIM) MOC Part 2
    Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.00 MOC points in the American Board of Medicine’s (ABIM) Maintenance of Certification (MOC) program. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.
  • 1.00 American Board of Surgery (ABS) Accredited CME
    Successful completion of this CME activity enables the learner to earn credit toward the CME requirement of the American Board of Surgery’s Continuous Certification program. It is the CME activity provider's responsibility to submit learner completion information to ACCME for the purpose of granting ABS credit.
  • 1.00 AMA PRA Category 1 Credit™
    The A. Webb Roberts Center for Continuing Medical Education of Baylor Scott & White Health is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
  • 1.00 Attendance

Price

Cost:
$25.00
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