Endothelial Dysfunction in Reversible Cerebral Vasoconstriction Syndrome
Condition: Reversible Cerebral Vasoconstriction Syndrome
MeSH terms: Syndrome
Study type: Observational

Summary: 
      Reversible Cerebral Vasoconstriction Syndrome (RCVS) is a syndrome described at the end of
      the 20th century. Generally, it has a benign course. It is revealed by acute headaches, in
      different circumstances such as sexual activity, physical exertion or emotional disturbances.
      But, in few cases, it might be complicated by seizure, stroke and subarachnoid haemorrhage.
      The diagnosis is confirmed on radiological examination, which shows diffuse cerebral
      vasoconstriction of brain vessel. It calls reversible because at three month,
      vasoconstriction disappears. Most cases occur during post partum or after
      serotoninergic/adrenergic drug use. The pathophysiology is unknown but a transient
      disturbance in the control of cerebrovascular tone by sympathic hyperactivity and/or
      endothelial dysfunction are suspected. The assessment of endothelial dysfunction in brain is
      possible with transcranial doppler. Chen et al. showed an impairment of vasodilatation post
      apnea induced called BHI on RCVS subjects compared with healthy control. BHI is a reflect of
      endothelial function in brain. Currently, investigators do not know if endothelial
      dysfunction occurred only in brain or if it may occur in systemic vessel. Some case reports
      talk about systemic complication such as kidney infarct or hepatic arterial vasospasm so a
      systemic vascular dysfunction may be suspected. In this study, researchers will study
      systemic endothelial function by measure of the pulse wave velocity during RCVS and after its
      recovering at 3 months, and compare it at healthy controls.
    

Detailed description: 
      The investigators lead a case control study to find a systemic endothelial dysfunction by the
      using of Complior device. Complior is a mechanographer who calculates pulse wave velocity
      (PWV). Pulse wave velocity is a reflect of arterial stiffness and it's correlate with
      endothelial dysfunction. For BHI, a Philips echograph is used before and after 30 second of
      breath holding.

      Study protocol is :

      For Patient :

        -  Day 0 : in hospital : anamnesis, medical history, physic examination, EKG, blood sample
           analysis, BHI, PWV analysis

        -  Month 1 : in medical visit : medical evolution, physic examination, EKG, blood sample
           analysis, BHI, PWV analysis

        -  Month 3 : in medical visit : medical evolution, physic examination, EKG, blood sample
           analysis, BHI, PWV analysis, cerebral angioCT Scan

      For control :

      - Day 0 : in hospital : medical history, physic examination, EKG, BHI, PWV analysis
    

Observational model: Case-Only
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Patients and Healthy subjects
      
Keywords: Endothelial dysfunction; Reversible cerebral vasoconstriction syndrome; Arterial stiffness; Breath holding index; Pulse wave velocity