A 60-year-old woman on venlafaxine presented with headache and left-sided weakness 1 month after undergoing right common carotid artery stenting. Catheter-based angiogram identified new irregularities of the right anterior cerebral and right middle cerebral artery (figure, A–C). Investigations for vasculitis, including CSF studies, were unremarkable. The vessel irregularities and symptoms improved after administration of intra-arterial verapamil (figure, D–F). Unilateral reversible cerebral vasoconstriction syndrome has previously been described after carotid endarterectomy. The mechanism is unclear; however, it may be due to disturbance of cerebral autoregulation.1,2 Concomitant use of a serotonin and norepinephrine reuptake inhibitor may have been a predisposing factor.
Original Article: http://www.neurology.org/cgi/content/short/83/6/570?rss=1
Júlio Pereira
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