An Autopsy Case of Reversible Cerebral Vasoconstriction Syndrome After a Severe Acute Respiratory Syndrome Coronavirus 2 Vaccination

A 73-year-old man with chronic obstructive pulmonary disease received the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mRNA vaccine. The following day, the patient developed a headache, followed by a tonic-clonic seizure and decreased consciousness. Magnetic resonance imaging of the head revealed no signs of stroke but multiple vasoconstrictions. Despite antiepileptic therapy, the seizure persisted, and the patient died 40 hours after vaccination. An autopsy revealed multiple brain ischemia without any vascular lesions, suggesting reversible cerebral vasoconstriction syndrome (RCVS). In this case, RCVS was diagnosed radiographically and pathologically. Our case suggests that RCVS could be a cause of headache and epilepsy following the SARS-CoV-2 mRNA vaccination.