Evidence map›Paper›PMID 33509852›Full record

ArticleBMJ case reports2021

Reversible cerebral vasoconstriction syndrome (RCVS) caused by over-the-counter calcium supplement ingestion.

Adam Ross Schertz, Anand Karthik Sarma, Sudhir Datar, Peter John Miller

Abstract readCase Reports
In one paragraph

Article in BMJ case reports, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Adam Ross SchertzDepartment of Internal Medicine, Section on Pulmonary, Critical Care, Allergy and Immunological Diseases, Wake Forest Baptist Health, Winston-Salem, North Carolina, USA.
Anand Karthik SarmaDepartment of Neurology, Section on Neurocritical Care, Wake Forest Baptist Health, Winston-Salem, North Carolina, USA.
Sudhir DatarDepartment of Neurology, Section on Neurocritical Care, Wake Forest Baptist Health, Winston-Salem, North Carolina, USA.
Peter John MillerDepartment of Internal Medicine, Section on Pulmonary, Critical Care, Allergy and Immunological Diseases, Wake Forest Baptist Health, Winston-Salem, North Carolina, USA pemiller@wakehealth.edu.

Funding

CVD Epidemiology Training ProgramT32HL076132 · NHLBI · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI DAVID McLeod HERRINGTON · 2004 to 2026
$8.4M
NHLBI NIH HHS T32 HL076132
6 · The paper itself

Abstract

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 mg/dL (corrected serum calcium for albumin concentration was 16.8 mg/dL). Extensive workup for intrinsic aetiology of hypercalcemia was unrevealing. Further discussion with family members and investigation of the patient's 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.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.

Indexed as

AntacidsBrainCalcium CarbonateHypercalcemiaVasospasm, IntracranialCalcium Channel BlockersCerebral AngiographyComputed Tomography AngiographyFemaleHumansMagnetic Resonance ImagingMiddle AgedNimodipineAntacidsCalcium CarbonateCalcium Channel BlockersNimodipineadult intensive caredrugs and medicinesdrugs: CNS (not psychiatric)neurological injurystroke

Identifiers

PMID33509852
PMCPMC7845714

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.