{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T19:10:20Z","timestamp":1779304220105,"version":"3.51.4"},"reference-count":15,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2021,5,8]],"date-time":"2021-05-08T00:00:00Z","timestamp":1620432000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Research Foundation of Korea","award":["NRF-2018R1C1B5086320"],"award-info":[{"award-number":["NRF-2018R1C1B5086320"]}]},{"name":"Hallym University Research Fund 2020","award":["HURF-2020-37"],"award-info":[{"award-number":["HURF-2020-37"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Reversible cerebral vasoconstriction syndromes (RCVS) is a rare disease that is characterized by reversible multifocal stenosis of the cerebral arteries with various clinical manifestations. Though the pathomechanism of RCVS was unclear, we reported RCVS related to the levonorgestrel-releasing intrauterine system (IUS). A previous healthy 36-year-old woman had thunderclap headache after implanting the levonorgestrel-releasing IUS a year ago. In the serial angiography, we initially found left vertebra artery (VA), and then additionally new stenosis of both anterior cerebral arteries and middle cerebral arteries (MCA). Bilateral MCA stenosis improved but developed stenosis of right VA after a week. The mean flow velocities of both MCA increased in the first transcranial doppler (TCD), but normalized in the follow up TCD. Levonorgestrel might act as the vasoconstrictitve factor that increased the level of endothelin-1, diminished the release of NO and raised oxidative low-density lipoprotein (LDL). Although the exact pathological mechanisms for RCVS were not yet elucidated, this case might help clinicians understand the mechanisms of RCVS.<\/jats:p>","DOI":"10.3390\/brainsci11050601","type":"journal-article","created":{"date-parts":[[2021,5,9]],"date-time":"2021-05-09T21:32:46Z","timestamp":1620595966000},"page":"601","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Reversible Cerebral Vasoconstriction Syndrome Associated with Levonorgestrel-Releasing Intrauterine System"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6830-2326","authenticated-orcid":false,"given":"Sangwon","family":"Choi","sequence":"first","affiliation":[{"name":"Department of Neurology, Chuncheon National Hospital, Chuncheon 24409, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1399-5927","authenticated-orcid":false,"given":"Ju-Young","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Neurology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul 05355, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jong","family":"Bae","sequence":"additional","affiliation":[{"name":"Department of Neurology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul 05355, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hong-Ki","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Neurology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul 05355, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ju-Hun","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Neurology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul 05355, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7108-6302","authenticated-orcid":false,"given":"Yerim","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Neurology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul 05355, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,5,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"906","DOI":"10.1016\/S1474-4422(12)70135-7","article-title":"Reversible cerebral vasoconstriction syndrome","volume":"11","author":"Ducros","year":"2012","journal-title":"Lancet Neurol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"3091","DOI":"10.1093\/brain\/awm256","article-title":"The clinical and radiological spectrum of reversible cerebral vasoconstriction syndrome. 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