Diagnostic Differentiation of RCVS from Primary CNS Vasculitis

Angiographic Overlap

• The American College of Radiology reports that reversible cerebral vasoconstriction syndrome (RCVS) exhibits significant angiographic overlap with primary central nervous system (CNS) vasculitis, as both conditions can display multifocal intracranial arterial stenosis and dilatation, creating potential diagnostic confusion. 1

Vessel‑Wall Imaging

• Contrast‑enhanced MRI vessel‑wall imaging can help distinguish the two entities: CNS vasculitis usually shows vessel‑wall inflammation with contrast enhancement, whereas RCVS does not demonstrate such enhancement, making this imaging technique a useful adjunct in diagnosis. 2