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Reversible cerebral vasoconstriction syndromes (RCVS) comprise a group of diverse conditions, all characterized by reversible multi-focal narrowing of the cerebral arteries heralded by sudden (thunderclap), severe headaches with or without associated neurologic deficits. Reversible cerebral vasoconstriction syndromes are clinically important because they affect young persons and can be complicated by ischemic or hemorrhagic strokes. The differential diagnosis of RCVS includes conditions associated with thunderclap headache and conditions that cause irreversible or progressive cerebral artery narrowing, such as intracranial atherosclerosis and cerebral vasculitis. Misdiagnosis as primary cerebral vasculitis and aneurysmal subarachnoid hemorrhage is common because of overlapping clinical and angiographic features. However, unlike these more ominous conditions, RCVS is usually self-limited: Resolution of headaches and vasoconstriction occurs over a period of days to weeks. In this review, we describe our current understanding of RCVS; summarize its key clinical, laboratory, and imaging features; and discuss strategies for diagnostic evaluation and treatment. |
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adverse drug reaction
angiography,cerebral
antidepressant
cerebrovascular accident
cerebrovascular accident,young adult
differential diagnosis
drug induced neurologic disorders
headache
headache,severe
misdiagnosis
mortality
MRI,abnormal
MRI,angiography
MRI,diffusion weighted
neurologic disease,diagnoses of
prognosis
reversible cerebral vasoconstrictive syndromes
selective serotonin reuptake inhibitors
treatment of neurologic disorder
vasculitides,benign cerebral
vasospasm,cerebral
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