Reversible cerebral vasoconstriction syndrome
| Reversible cerebral vasoconstriction syndrome | |
|---|---|
| Synonyms | Call-Fleming syndrome, Thunderclap headache |
| Pronounce | N/A |
| Specialty | N/A |
| Symptoms | Severe headache, nausea, vomiting, visual disturbances, seizures |
| Complications | Stroke, subarachnoid hemorrhage |
| Onset | Sudden |
| Duration | Days to weeks |
| Types | N/A |
| Causes | Unknown, possible triggers include vasoactive substances, pregnancy, migraine, physical exertion |
| Risks | Female gender, migraine history, postpartum period |
| Diagnosis | Clinical diagnosis, MRI, angiography |
| Differential diagnosis | Subarachnoid hemorrhage, migraine, cerebral vasculitis |
| Prevention | N/A |
| Treatment | Calcium channel blockers, pain management, hydration |
| Medication | N/A |
| Prognosis | Generally good with treatment |
| Frequency | Rare |
| Deaths | N/A |
Reversible cerebral vasoconstriction syndrome (RCVS) is a rare condition characterized by a group of disorders featuring reversible constriction of the cerebral arteries. The primary symptom of RCVS is a sudden, severe headache, often described as the "worst headache of my life".
Symptoms
The most common symptom of RCVS is a sudden, severe headache, often described as a "thunderclap headache". This headache is typically at its worst at onset and may be associated with nausea, vomiting, and sensitivity to light. Other symptoms can include seizures, focal neurological deficits, and visual disturbances.
Causes
The exact cause of RCVS is unknown. However, it has been associated with various conditions and triggers, including pregnancy, the postpartum period, exposure to certain drugs (such as selective serotonin reuptake inhibitors, triptans, and pseudoephedrine), and certain medical procedures.
Diagnosis
Diagnosis of RCVS is typically based on the clinical presentation and imaging findings. The diagnosis can be confirmed by demonstrating the reversibility of the vasoconstriction on follow-up imaging.
Treatment
Treatment for RCVS is primarily supportive, as the condition is self-limiting and typically resolves on its own within three months. However, in some cases, medication may be used to help manage symptoms and prevent complications.
Prognosis
The prognosis for RCVS is generally good, with most patients experiencing complete resolution of symptoms within three months. However, in rare cases, RCVS can lead to serious complications such as stroke or brain hemorrhage.
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Contributors: Prab R. Tumpati, MD