Updated June 17, 2014.

Question: What Is Reversible Cerebral Vasoconstriction Syndrome?

Answer:

Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by two main features. The first one is the sudden onset of a thunderclap headache. The second one is the presence of areas of narrowing or "vasoconstriction" where the wall of one or more arteries in the brain experience a cramp that prevents blood flow. These areas can be easily diagnosed by a catheter angiogram, although sometimes it can also be seen with magnetic resonance angiography (MRA).

Reversible cerebral vasoconstriction may or may not lead to stroke. In many cases, stroke symptoms occur but are completely reversed later. However, some people may be left with permanent deficits. The event may also cause seizures and death.

RCVS can cause either ischemic or hemorrhagic strokes, typically in the form of a subarachnoid hemorrhage.

Who Is Affected by RCVS?

RCVS affects women more often than men, being most common after having given birth.

What Causes RCVS?

The cause of RCVS is not known, but it is thought that it results from a transient disturbance of the arterial wall, which leads to its constriction. Several substances have been associated with RCVS, including:

• Selective serotonin reuptake inhibitors (SSRIs)
• Nasal decongestants containing pseudoephedrine or ephedrine
• Ergotamine
• Tacrolimus
• Nicotime patches
• Cocaine
• Marijuana

_Source:

Anne Ducros, Monique Boukobza, Raphaël Porcher, Mariana Sarov, Dominique Valade and Marie-Germaine Bousser; The clinical and radiological spectrum of reversible cerebral vasoconstriction syndrome.

A prospective series of 67 patients: Brain 2007 130(12):3091-3101