Successful Corticosteroid Treatment of Refractory Spontaneous Vasoconstriction of Extracranial Internal Carotid and Coronary ArteriesTakeuchi, Mariko MD; Saito, Kozue MD, PhD; Kajimoto, Katsufumi MD, PhD; Nagatsuka, Kazuyuki MD, PhDNeurologist: July 2016 - Volume 21 - Issue 4 - p 55–57 doi: 10.1097/NRL.0000000000000080 Case Report/Case Series Abstract Author Information Introduction: Spontaneous vasoconstriction of the extracranial internal carotid artery (SVEICA) is a rare cause of cerebral infarction. Most patients with SVEICA suffer recurrent attacks of vasoconstriction. The standard treatment for this condition has not been established and its long-term prognosis is unclear. Case Report: A 25-year-old man with a history of refractory vasospasm angina presented with transient alternating hemiplegia in both the right and left side. Serial carotid ultrasonography examinations showed severe transient stenosis or occlusion of cervical internal carotid arteries on 1 or both sides, with and without neurological symptoms. This condition resolved completely within 1 day to 1 week. The patient did not present any other risk factors for atherosclerosis and was diagnosed with SVEICA. The treatment with calcium antagonists and nitrates did not prevent the attacks. Administration of a corticosteroid substantially reduced the vasospasm attacks. Conclusions: SVEICA is intractable and difficult to diagnose. It has been reported that SVEICA sometimes complicates coronary artery disease, as observed in this case. The present case demonstrated the effectiveness of corticosteroid treatment against this disease. Serial ultrasonography examinations helped us to diagnose and follow-up the vasospasm attacks. Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan The authors declare no conflict of interest. Reprints: Mariko Takeuchi, MD, Department of Neurology and Stroke Center, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan. E-mail: firstname.lastname@example.org. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially. http://creativecommons.org/licenses/by-nc-nd/4.0/ Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.