See the published version of this preprint at The Journal of Headache and Pain.
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Case report
Mansoureh Togha
Professor of neurology, Sina Hospital, School of Medicine, Tehran University of Medical Sciences; Headache department, Irainian Center of Neurological Researches, Institute of Neuroscience, Tehran University of Medical Sciences.
Corresponding Author
ORCiD: https://orcid.org/0000-0002-9368-6835
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
Reversible Cerebral Vasoconstriction Syndrome is a condition of transient cerebral vascular spasms presenting with recurrent thunderclap headaches and recovery within three months. Several probable triggers and underlying factors, such as sex hormones, vasoactive drugs, head trauma or surgery, and tumors, have been implicated.
Case presentation
In this paper, we present a 53-year-old woman with severe thunderclap headaches and normal lab tests who was radio-clinically diagnosed with reversible cerebral vasoconstriction syndrome and treated accordingly. Then, she experienced the recurrence of RCVS after about 2 years and headaches after one year in association with high blood pressure, high blood sugar, hypothyroidism, hyperlipidemia, and a urine metanephrine level of 5 times higher than the normal limit, suggesting a diagnosis of pheochromocytoma. After confirmation of the diagnosis with further imaging studies, surgical removal of the tumor resolved all the signs and symptoms.
Conclusion
Often underdiagnosed, pheochromocytoma could be an important condition associated with RCVS. It is important for clinicians to bear this diagnosis in mind while dealing with similar cases of recurrent thunderclap headaches.
Keywords
Pheochromocytoma, Reversible Cerebral Vasoconstriction Syndrome, Thunder-clap Headache
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CURRENT STATUS: Published
View the published article at The Journal of Headache and Pain.
Version 1
Posted 16 Jan, 2021
No community comments so far
Editorial decision: Major revision
On 29 Jan, 2021
Review #2 received
Received 26 Jan, 2021
Reviewer #2 agreed
On 11 Jan, 2021
Reviewers invited
Invitations sent on 08 Jan, 2021
Reviewer #1 agreed
On 08 Jan, 2021
Review #1 received
Received 08 Jan, 2021
Editor assigned
On 06 Jan, 2021
Submission checks complete
On 06 Jan, 2021
Editor invited
On 06 Jan, 2021
First submitted
On 28 Dec, 2020
Metrics
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PDF Downloads: ...
HTML Views: ...
Subject Areas
Head & Neck Surgery
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A new preprint design is coming!
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See the published version of this preprint at The Journal of Headache and Pain.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Case report
Mansoureh Togha
Professor of neurology, Sina Hospital, School of Medicine, Tehran University of Medical Sciences; Headache department, Irainian Center of Neurological Researches, Institute of Neuroscience, Tehran University of Medical Sciences.
Corresponding Author
ORCiD: https://orcid.org/0000-0002-9368-6835
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at The Journal of Headache and Pain.
Version 1
Posted 16 Jan, 2021
No community comments so far
Editorial decision: Major revision
On 29 Jan, 2021
Review #2 received
Received 26 Jan, 2021
Reviewer #2 agreed
On 11 Jan, 2021
Reviewers invited
Invitations sent on 08 Jan, 2021
Reviewer #1 agreed
On 08 Jan, 2021
Review #1 received
Received 08 Jan, 2021
Editor assigned
On 06 Jan, 2021
Submission checks complete
On 06 Jan, 2021
Editor invited
On 06 Jan, 2021
First submitted
On 28 Dec, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Head & Neck Surgery
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at The Journal of Headache and Pain.
Background
Reversible Cerebral Vasoconstriction Syndrome is a condition of transient cerebral vascular spasms presenting with recurrent thunderclap headaches and recovery within three months. Several probable triggers and underlying factors, such as sex hormones, vasoactive drugs, head trauma or surgery, and tumors, have been implicated.
Case presentation
In this paper, we present a 53-year-old woman with severe thunderclap headaches and normal lab tests who was radio-clinically diagnosed with reversible cerebral vasoconstriction syndrome and treated accordingly. Then, she experienced the recurrence of RCVS after about 2 years and headaches after one year in association with high blood pressure, high blood sugar, hypothyroidism, hyperlipidemia, and a urine metanephrine level of 5 times higher than the normal limit, suggesting a diagnosis of pheochromocytoma. After confirmation of the diagnosis with further imaging studies, surgical removal of the tumor resolved all the signs and symptoms.
Conclusion
Often underdiagnosed, pheochromocytoma could be an important condition associated with RCVS. It is important for clinicians to bear this diagnosis in mind while dealing with similar cases of recurrent thunderclap headaches.
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