{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T19:09:09Z","timestamp":1779304149818,"version":"3.51.4"},"reference-count":16,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,6,12]]},"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:p>A 59-year-old woman was found unresponsive at home. Initial neurologic examination revealed aphasia and right-sided weakness. Laboratory results demonstrated a serum calcium level of 17.3\u2009mg\/dL (corrected serum calcium for albumin concentration was 16.8\u2009mg\/dL). Extensive workup for intrinsic aetiology of hypercalcemia was unrevealing. Further discussion with family members and investigation of the patient\u2019s home for over-the-counter medications and herbal supplements revealed chronic ingestion of calcium carbonate tablets. CT angiogram of the brain revealed multifocal intracranial vascular segmental narrowing, which resolved on a follow-up cerebral angiogram done 2 days later. These findings were consistent with reversible cerebral vasoconstriction syndrome.<\/jats:p>\n               <jats:p>Appropriate blood pressure control with parenteral agents, calcium channel blockade with nimodipine and supportive care therapies resulted in significant improvement in neurologic status. By discharge, patient had near-complete resolution of neurologic symptoms.<\/jats:p>","DOI":"10.1136\/bcr-2019-233877","type":"journal-article","created":{"date-parts":[[2021,1,28]],"date-time":"2021-01-28T12:46:12Z","timestamp":1611837972000},"page":"e233877","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Reversible cerebral vasoconstriction syndrome (RCVS) caused by over-the-counter calcium supplement ingestion"],"prefix":"10.1136","volume":"14","author":[{"given":"Adam Ross","family":"Schertz","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Section on Pulmonary, Critical Care, Allergy and Immunological Diseases, Wake Forest Baptist Health, Winston-Salem, North Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anand Karthik","family":"Sarma","sequence":"additional","affiliation":[{"name":"Department of Neurology, Section on Neurocritical Care, Wake Forest 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