Call-Fleming syndrome

Last revised by Frank Gaillard on 13 Jan 2019

Call-Fleming syndrome, also called Call syndrome, essentially synonymous with the more current term reversible cerebral vasoconstriction syndrome (RCVS), although it is felt to be a subset of the former by some, representing the idiopathic RCVS. 

Call-Flemming syndrome is therefore characterized by a history of a thunderclap headache with subsequent beaded appearance of the circle of Willis on angiography but with no identifiable cause. Further clinical, pathological and imaging features are discussed within the reversible cerebral vasoconstriction syndrome article. 

History and etymology

It was first described by Call and Fleming et al, in 1988 2 where they described 19 patients with "reversible cerebral arterial segmental vasoconstriction", who presented with thunderclap headaches with or without focal neurology, without evidence of subarachnoid hemorrhage. A number of predisposing factors have since been found to contribute to what is now described as RCVS. However, idiopathic cases of RCVS still exist and are now named Call-Fleming.

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