Reversible cerebral vasoconstriction syndrome: A narrative review - PubMed
3 hours ago
- #neuroimaging
- #thunderclap headache
- #cerebrovascular disorders
- RCVS is characterized by recurrent thunderclap headaches and transient segmental vasoconstriction of cerebral arteries, typically resolving within 3 months.
- Triggers include vasoactive substances, pregnancy, postpartum state, and physical or emotional stress.
- Complications can include subarachnoid hemorrhage, ischemic stroke, and cerebral edema.
- Differentiating RCVS from conditions like primary angiitis of the CNS, aneurysmal SAH, and cerebral venous thrombosis is crucial due to overlapping features but differing treatments.
- Advances in neuroimaging, such as MRA and vessel wall imaging, have improved diagnostic accuracy.
- Management focuses on eliminating triggers and symptomatic support; calcium channel blockers are commonly used, though their impact on disease evolution is uncertain.
- Many patients recover without major sequelae, but chronic symptoms like long-term headaches and cognitive impairment suggest a post-RCVS syndrome, requiring ongoing follow-up.