Document Detail

Reversible segmental cerebral vasoconstriction (Call-Fleming syndrome): are calcium channel inhibitors a potential treatment option?
MedLine Citation:
PMID:  12662190     Owner:  NLM     Status:  MEDLINE    
The Call-Fleming syndrome is characterized by sudden onset of thunderclap-like headache and focal neurological deficits. The pathophysiological correlate is a reversible segmental cerebral vasoconstriction frequently associated with focal cerebral ischaemia. The syndrome has been described in a variety of clinical conditions, and recently an association between the syndrome and exposure to vasoactive drugs was observed. Effective treatment options are not known. A 63-year-old female developed sudden 'worst ever' headache. Initial neurological examination, laboratory blood tests, CSF examination and brain magnetic resonance imaging (MRI) were normal. Previous medical history was unremarkable and she did not take vasoactive drugs. Eleven days after the onset of headache she developed visual field impairment and a right-sided hemiparesis. Brain MRI revealed bilateral posterior and left parietal ischaemic strokes. Cerebral catheter angiography showed segmental arterial vasoconstriction. A vasodilative therapy with calcium channel inhibitors was started and serial transcranial Doppler ultrasonography demonstrated resolution of cerebral arterial vasoconstriction. The present case illustrates that calcium channel inhibitors may be an effective therapy for segmental cerebral arterial vasoconstriction. However, more clinical data are needed to prove this observation.
D A Nowak; S O Rodiek; S Henneken; J Zinner; R Schreiner; H-H Fuchs; H Topka
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Cephalalgia : an international journal of headache     Volume:  23     ISSN:  0333-1024     ISO Abbreviation:  Cephalalgia     Publication Date:  2003 Apr 
Date Detail:
Created Date:  2003-03-28     Completed Date:  2003-05-30     Revised Date:  2008-02-11    
Medline Journal Info:
Nlm Unique ID:  8200710     Medline TA:  Cephalalgia     Country:  England    
Other Details:
Languages:  eng     Pagination:  218-22     Citation Subset:  IM    
Department of Neurology and Clinical Neurophysiology, Academic Hospital München Bogenhausen, Technical University of Munich, Munich, Germany.
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MeSH Terms
Calcium Channel Blockers / therapeutic use*
Cerebral Angiography / methods
Constriction, Pathologic
Magnetic Resonance Imaging / methods
Nimodipine / therapeutic use
Vasospasm, Intracranial / diagnosis,  drug therapy*
Reg. No./Substance:
0/Calcium Channel Blockers; 66085-59-4/Nimodipine
Comment In:
Cephalalgia. 2003 Apr;23(3):163-5   [PMID:  12662181 ]

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