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RCVS: An Unusual But Treatable Cause Of Headache

Author(s): Asheesh Kumar, Sudhir Sharma, Balbir Verma, Ashok Sharma

Introduction: Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by severe headaches, with or without other acute neurological symptoms, and diffuse segmental constriction of cerebral arteries that resolves spontaneously within 3 months. The mean age of onset is 42 years, and it affects more women than men. RCVS is possibly caused by a transient dysregulation of cerebral vascular tone, leading to multi-focal arterial constriction and dilation. Approximately 60% of the cases are secondary to a known likely cause. Case Report: We report the case of 20 year old female with severe headache, due to vasospasm of vessels with intraparenchymal haemorrhage and spasm that relieved spontaneously in 7 weeks documented with repeat MRI. Conclusion: RCVS is a secondary cause of headache. Patients who have thunderclap headache with normal brain CT and cerebrospinal fluid without xanthochromia should be investigated for reversible cerebral vasoconstriction syndrome.