Reversible Cerebral Vasoconstriction Syndrome (RCVS) overview

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Reversible Cerebral Vasoconstriction Syndrome (RCVS)

Thunderclap headache: severity reach maximum intensity within 1 minutes

Subarachnoid hemorrhage or isolated sentinel leak before aneurysmal rupture or RCVS

3 episodes within 4 days -->CT, LP normal ---> RCVS

Multifocal constriction of intracranial vessels that normalizes within 3 months of onset

Brain MRA or head CTA

Predisposing drugs: sympathomimetic agents, Triptans, cocaine, cannabis, SSRI

Valsalva maneuver, emotion, showering/bathing

Focal deficit, encephalopathy , seizure

CCB (verapamil) or nimodipine -->Tx RCVS