In plain words
Reversible cerebral vasoconstriction syndrome, or RCVS, is a rare condition in which the blood vessels of the brain narrow for a time and then recover. It often starts with a sudden, severe headache, sometimes described as the worst of a lifetime, and it can come with seizures, weakness, or changes in vision or speech. In pregnancy and the weeks after birth, it is one of several serious causes of headache that clinicians must rule out. Most people recover over weeks, but some have lasting effects, and some have strokes. A sudden, severe headache, especially one that is new or different, is a reason to call 911 or go to the emergency room now. Ordinary headaches have many causes, and most are not this.
The deeper version
RCVS is a syndrome of reversible segmental vasoconstriction of intracranial arteries, usually presenting with recurrent over one to three weeks, with angiographic changes that typically resolve within about 12 weeks. Postpartum onset is recognized, and pregnancy and the puerperium are among its associated settings, alongside serotonergic and vasoactive drugs and cannabis. Diagnosis rests on angiographic demonstration of segmental narrowing and on exclusion of other causes, including subarachnoid hemorrhage, posterior reversible encephalopathy, , and pituitary apoplexy. Complications include ischemic stroke, intracerebral hemorrhage, and seizures. Ducros and colleagues (2007, Brain) described the clinical spectrum, and Ducros (2012, Lancet Neurology) reviewed the syndrome. Pathophysiology is not fully established.
Where it comes up
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Sources
- Ducros A, Boukobza M, Porcher R, et al. — The clinical spectrum of reversible cerebral vasoconstriction syndrome. Brain (2007)
- Ducros A — Reversible cerebral vasoconstriction syndrome. The Lancet Neurology (2012)