Pediatric reversible cerebral vasoconstriction syndrome (RCVS) and spontaneous cervical internal carotid artery (ICA) vasospasm are rare conditions; the former is commonly associated with a favorable prognosis. A healthy 13-year-old girl presented with thunderclap headache, followed by left hemiparesis, during a curling match. Six days after onset, left hemiparesis worsened to hemiplegia. Magnetic resonance imaging showed progressive cerebral infarction caused by severe right middle cerebral artery and cervical ICA stenosis. She became comatose because of impending uncal herniation. Emergent surgical decompression was performed. Then, 59 days after onset, her multiple stenoses improved, which was consistent with RCVS concomitant with spontaneous cervical ICA vasospasm. This is the first case of RCVS that concurrently developed spontaneous cervical ICA vasospasm. The patient developed life-threatening stroke due to the hemodynamic impairment of the affected intracranial and cervical arteries. Spontaneous extracranial supra-aortic artery vasospasm can be a poor prognostic predictor of RCVS.

小儿可逆性脑血管收缩综合征 (RCVS) 和自发性颈内动脉 (ICA) 血管痉挛是罕见的疾病；前者通常与良好的预后相关。一名健康的 13 岁女孩在冰壶比赛期间出现霹雳性头痛，随后出现左侧偏瘫。发病六天后，左侧偏瘫恶化为偏瘫。磁共振成像显示由严重的右大脑中动脉和颈内动脉狭窄引起的进行性脑梗塞。由于即将发生的肛门疝，她陷入昏迷。进行了紧急手术减压。然后，在发病 59 天后，她的多处狭窄得到改善，这与伴随自发性颈椎 ICA 血管痉挛的 RCVS 一致。这是第一例同时发生自发性颈内动脉痉挛的 RCVS 病例。由于受影响的颅内和颈动脉的血流动力学障碍，患者发展为危及生命的中风。自发性颅外主动脉上动脉血管痉挛可能是 RCVS 的不良预后预测因子。