Neurology: Urinary retention-induced reversible cerebral vasoconstriction syndrome

18 years old, male
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Quadriplegia below C6 after traumatic accident
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2 sudden 30min thunderclap headaches, vision loss, new onset urinary incontinence, hypertension (200s/90s [Translator's Note: What unit is this]) and bradycardia over 24 hours
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Imaging showed multiple cerebral stenosis (Figure 1), diffusion suppression, and T2/FLAIR hyperintensity (Figure 2); transcranial Doppler (TCD) showed increased blood flow velocity
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Figure 1.
(A) Spinal hardware implanted after a traumatic accident
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Figure 2.
(A) and (B) MRI on admission; DWI (A) and ADC (B) sequences showing acute left parieto-occipital infarction
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Neurogenic bladder can trigger autonomic dysreflexia (ered autonomic dysreflexia, AD), thereby triggering RCV
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Injury above the level of the T6 spinal cord eliminates supraspinal modulation and can lead to AD, an excessive sympathetic reflex, resulting in episodic hypertension and bradycardia.
tachycardia)
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Christina M.