Reversible Cerebral Vasoconstriction Syndrome

Sneddon's syndrome (SS) refers to an infrequent disorder combining skin and ischemic cerebral lesions in patients without a recognizable connective tissue or inflammatory or chronic infectious disease. As a rule, the transient ischemic attacks and strokes are multiple and recurrent in the same or different vascular territories. Both cortical and subcortical areas in the anterior and posterior circulation can be affected, but the most common lesions leading to progressive clinical disability are white matter abnormalities and lacunar infarcts. A large retrospective study on the anti-phospholipid antibody syndrome demonstrated that treatment with high-intensity warfarin (producing an international normalized ratio [INR] of >3) with or without low-dose aspirin (75 mg/day) is significantly more effective than treatment with low-intensity warfarin (producing an INR of <3) with or without treatment with low-dose aspirin or treatment with aspirin alone in preventing further thrombotic events.