This may involve a CT scan, lumbar puncture, MRI, and other tests. Posterior reversible encephalopathy syndrome has a similar presentation, and is found in 10–38% of RCVS patients.RCVS is diagnosed by detecting diffuse reversible cerebral vasoconstriction. Catheter angiography is ideal, but computed tomography angiography and magnetic resonance angiography can identify about 70% of cases. Multiple angiographies may be necessary. Because other diseases (such as atherosclerosis) have similar angiographic presentations, it can only be conclusively diagnosed if vasoconstriction resolves within 12 weeks. Treatment
As of 2014, no treatment strategy has yet been investigated in a randomized clinical trial. Verapamil, nimodipine, and other calcium channel blockers may help reduce the intensity and frequency of the headaches. A clinician may recommend rest and the avoidance of activities or vasoactive drugs which trigger symptoms (see § Causes). Analgesics and anticonvulsants can help manage pain and seizures, respectively. Prognosis
All symptoms normally resolve within three weeks, and may only last days. Permanent deficits are seen in a minority of patients, ranging from under 10% to 20% in various studies. Less than 5% of patients experience progressive vasoconstriction, which can lead to stroke, progressive cerebral edema, or even death. Severe complications appear to be more common in postpartum mothers. Epidemiology
The incidence of RCVS is unknown, but it is believed to be "not uncommon", and likely under-diagnosed.
The study suggests that both the mutant enzyme and an abnormally high blood glucose level were necessary to cause Mauriac syndrome. Treatment
Symptoms are improved when patient attain tighter control of their blood sugars. The generally accepted therapeutic approach is intensified multiple insulin injection therapy; however, this may cause development of retinopathy if the blood sugars are adjusted too quickly. In one study, a patient was transferred to continuous insulin delivery, which resulted in improvement of his symptoms and greater control of his blood sugars. == References ==