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Curriculum · Neurology

Reversible cerebral vasoconstriction syndrome

What it is

Reversible cerebral vasoconstriction syndrome is one of the two most common causes of a thunderclap headache. Its name says what is found: multifocal areas of vasoconstriction in bilateral cerebral arteries, the MCA, the ACA and the PCA.

How it presents

The headache is a very severe occipital pain that starts and reaches maximal intensity instantaneously, and then falls back to a moderate holocephalic headache. Episodic migraines and depression were reported alongside it. The blood pressure may be mildly raised, 145/92 for example, with an otherwise normal examination.