Recurrent extracranial vasospasm

Neurovascular medicine is full of surprises. On Tuesday we saw a patient during our CME rounds that suffers from recurrent extracranial vasospasms and that for twenty years now. Last year he developed a proper stroke and was stented. This year the artery is stenotic again and he went through various interventions until we realized that his arteries are just too sensitive – we then switched to nimodipine and spasms remitted, only to develop on the other side.

This really is a very young disease entity, first described by Janzarik et al in Stroke 2006. It seems to have nothing to do with migraine, vasculitis, RCVS.