A case of RCVS with PRES diagnosed by thunderclap headache, result in successful allogeneic bone marrow transplantation with continuing tacrolimus

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  • 雷鳴頭痛よりPRESを合併したRCVSと診断し，タクロリムスを継続できた同種骨髄移植例

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<p>　A 48-year-old female underwent allogeneic bone marrow transplantation for severe aplastic anemia. She complained of thunderclap headache at night after tacrolimus (Tac) administration. Although MRI at symptom onset showed posterior reversible encephalopathy syndrome （PRES）, we suspected reversible cerebral vasoconstriction syndrome （RCVS） from the thunderclap headache. The white matter lesions of PRES improved after transient worsening, despite continuing the transplantation with Tac. But vasospasm appeared a few days later and gradually improved after lomerizine treatment. She was diagnosed as RCVS. Tac often induce PRES, but it’s relationship to RCVS is reported fewer, and uncertain. We could continue Tac with a diagnosis of RCVS. Therefore, symptoms is more important than images in RCVS with PRES.</p>

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