Review
Clinical Neurology
Chun-Yu Chen, Jong-Ling Fuh
Summary: TCH is a sudden severe headache that requires thorough investigation, with SAH being the most common secondary cause. The latest guideline from the American College of Emergency Physicians suggests that a negative noncontrast brain CT essentially rules out SAH, and recommends CT angiogram as an alternative if suspicion of intracranial SAH is high.
CURRENT OPINION IN NEUROLOGY
(2021)
Article
Clinical Neurology
Kristin Sophie Lange, Gabrielle Tuloup, Claire Duflos, Claire Gobron, Cecilia Burcin, Lucas Corti, Caroline Roos, Anne Ducros, Jerome Mawet
Summary: Reversible cerebral vasoconstriction syndrome (RCVS) complications vary according to age, with cervical artery dissections more common in young patients and haemorrhagic complications more common in older patients. Age does not impact functional outcome.
JOURNAL OF NEUROLOGY
(2023)
Review
Medicine, General & Internal
Vasileios Tentolouris-Piperas, Loukas Lymperopoulos, Argyro Tountopoulou, Sophia Vassilopoulou, Dimos D. Mitsikostas
Summary: Reversible cerebral vasoconstriction syndrome (RCVS) is a condition characterized by thunderclap headache and focal neurological symptoms or seizures. It can occur idiopathically or secondary to various trigger factors. The understanding of RCVS is still limited, and more research is needed to clarify its characteristics and associations.
Review
Clinical Neurology
Aneesh B. Singhal
Summary: Reversible cerebral vasoconstriction syndrome (RCVS) is a condition characterized by reversible narrowing of the intracranial arteries, predominantly affecting women. The main symptoms include recurrent severe headaches and abnormal brain imaging, which may lead to complications such as hemorrhage, ischemia, and edema. The pathophysiology is not yet fully understood, and treatment mainly focuses on symptomatic management and avoiding triggers.
INTERNATIONAL JOURNAL OF STROKE
(2023)
Review
Cell Biology
Shih-Pin Chen, Shuu-Jiun Wang
Summary: Reversible cerebral vasoconstriction syndrome (RCVS) is a complex neurovascular disorder characterized by sudden severe headaches and widespread cerebral vasoconstriction. The pathophysiology of RCVS is not fully understood, but dysfunction of cerebral vascular tone and impairment of blood-brain barrier are believed to play key roles. Other factors such as genetic predisposition, sympathetic overactivity, endothelial dysfunction, and oxidative stress may also contribute to the development of RCVS.
JOURNAL OF BIOMEDICAL SCIENCE
(2022)
Article
Clinical Neurology
Jonathan H. Smith, Mohammed A. Amer, Todd J. Schwedt
Summary: In individuals with reversible cerebral vasoconstriction syndrome (RCVS), thunderclap headache (TCH) can be identified using either a verbal descriptor scale (VDS) or numerical rating scale (NRS), with a wider range of peak intensities than previously recognized. TCH remains recognizable despite the presence of pre-existing baseline headache.
Article
Clinical Neurology
Fida Oukhai, Valerie Domigo, Joseph Benzakoun, Michel Wolff, Anne Ducros, Jean-Louis Mas, David Calvet
Summary: This article reports two cases of reversible cerebral vasoconstriction syndrome (RCVS) in patients with meningitis. Headache and artery irregularities resolved with the improvement of cerebrospinal fluid (CSF). These cases suggest that brain imaging should be performed to rule out RCVS when modifying or atypical headaches occur in the context of meningitis.
FRONTIERS IN NEUROLOGY
(2023)
Article
Medicine, General & Internal
Ricardo D. Otiniano-Sifuentes, Laura Zelada-Rios, Jorge Ramirez-Quinones, Carlos Abanto, Maria Novoa, Pilar Calle La Rosa, Nestor Flores, Lourdes Simbron-Ribbeck, Ana Valencia, Danny Barrientos-Iman
Summary: RCVS is an underdiagnosed condition that can lead to subarachnoid hemorrhage, characterized by thunderclap headache and focal vasoconstriction. Repeating angiographic studies in the second week of suspicion is crucial for diagnosis and treatment.
CUREUS JOURNAL OF MEDICAL SCIENCE
(2021)
Article
Clinical Neurology
Smit D. Patel, Karan Topiwala, Vasu Saini, Neel Patel, Mubashir Pervez, Fawaz Al-Mufti, Ameer E. Hassan, Priyank Khandelwal, Robert M. Starke
Summary: The study found that intracerebral hemorrhage is the most common vascular complication in hospitalized RCVS patients, leading to longer hospital stays, more invasive procedures, and higher healthcare costs. However, overall outcomes are excellent regardless of the type of intracerebral hemorrhage, with no inpatient mortality observed in patients with hemorrhagic RCVS. Female sex and middle to older age groups are associated with higher odds of intracerebral hemorrhage.
JOURNAL OF NEUROLOGY
(2021)
Article
Clinical Neurology
Todd D. Rozen, Alok A. Bhatt
Summary: A case study was presented where a 43-year-old woman developed reversible cerebral vasoconstriction syndrome after receiving calcitonin gene-related peptide monoclonal antibody treatment. Symptoms improved with verapamil and follow-up imaging showed resolution of vessel stenosis. Further studies are needed to investigate the potential link between the use of calcitonin gene-related peptide monoclonal antibodies and reversible cerebral vasoconstriction syndrome.
Article
Clinical Neurology
Kristin Sophie Lange, Ophelie Forster, Jerome Mawet, Gabrielle Tuloup, Cecilia Burcin, Lucas Corti, Claire Duflos, Caroline Roos, Anne Ducros
Summary: Patients with reversible cerebral vasoconstriction syndrome (RCVS) who do not present with thunderclap headache (TCH) at onset have a higher risk for neurological complications, including cervical artery dissections, posterior reversible encephalopathy syndrome, seizures, and subarachnoid hemorrhage, compared to those with TCH. However, the functional outcome at 3 months is similar in both groups, with most patients having a good prognosis. Further multicentric studies are needed to confirm these findings.
EUROPEAN JOURNAL OF NEUROLOGY
(2022)
Article
Clinical Neurology
Jessica Magid-Bernstein, Setareh S. Omran, Neal S. Parikh, Alexander E. Merkler, Babak Navi, Hooman Kamel
Summary: The study estimated the age- and sex-standardized incidence of hospitalization for reversible cerebral vasoconstriction syndrome (RCVS) in US adults to be approximately 3 cases per million per year. Many patients with RCVS had concomitant neurologic diagnoses, including subarachnoid hemorrhage, ischemic stroke, and intracerebral hemorrhage.
Review
Clinical Neurology
Deborah Katharina Erhart, Albert Christian Ludolph, Katharina Althaus
Summary: Reversible cerebral vasoconstriction syndrome is a common but potentially underdiagnosed condition characterized by thunderclap headache and widespread vasoconstriction. The pathophysiology is believed to involve sympathetic overactivity and endothelial dysfunction. Precipitating factors include the use of vasoactive substances and postpartum status.
JOURNAL OF NEUROLOGY
(2023)
Article
Clinical Neurology
Aayushi Garg, Marcelo Rocha, Matthew Starr, Santiago Ortega-Gutierrez
Summary: Intracranial hemorrhage occurs in nearly 42% of RCVS patients, and is associated with increased rates of other neurologic complications and adverse discharge disposition, challenging the prevailing notion that RCVS is generally a benign disorder with a self-limiting clinical course.
JOURNAL OF THE NEUROLOGICAL SCIENCES
(2021)
Article
Clinical Neurology
Genri Toyama, Shintaro Tsuboguchi, Kazuya Igarashi, Etsuji Saji, Takuya Konno, Osamu Onodera
Summary: We report a case of RCVS in the postpartum period with thunderclap headache exacerbated in the supine position, which resolved quickly in the standing position.