Narrative Review: Headaches After Reversible Cerebral Vasoconstriction Syndrome

Ling, Yu Hsiang; Chen, Wei–Ta

doi:10.1007/s11916-020-00908-1

Cited by 8 publications

(11 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The 3.6% with a thunderclap onset of all patients with NDPH in this series is similar to the 4% with a thunderclap onset in Jamali and Rozen's retrospective NDPH series (3/74) 28 . Robbins and Evans 25 and Jamali and Rozen 28 hypothesize that this thunderclap onset NDPH could be due to reversible cerebral vasoconstriction syndrome, 29 even though imaging studies were negative for cerebral vasospasm.…”

Section: Discussionsupporting

confidence: 78%

See 1 more Smart Citation

Clinical features of new daily persistent headache: A retrospective chart review of 328 cases

Evans

Turner

2021

Headache

View full text Add to dashboard Cite

Objective To describe the clinical features of new daily persistent headache (NDPH) at an outpatient neurology clinic with a subspecialty interest in headache in Houston, Texas. Methods A retrospective chart review was performed by a neurologist subspecialty certified in headache medicine of all patients seen from September 1, 2011 through February 28, 2020 (8.5 years) with a provisional diagnosis of NDPH and abstracted charts meeting criteria for primary NDPH. Results A total of 328 patients met the International Classification of Headache Disorders, 3rd edition criteria including 215 (65.5%) female patients. The mean age of onset was 40.3 years (range 12–87 years) with a mean age at first consultation in the study clinic of 42.6 years (range 12–87 years). The median [25th, 75th] duration of NDPH at initial consultation was 0.7 [0.3, 2.0] years, and at last visit, it was 1.9 [0.7, 4.8] years. The headaches were side‐locked unilateral in 28/328 (8.5%). 12/328 cases (3.6%) with a thunderclap onset are reported. There was no obvious seasonal or other cyclical variation. The pain was usually moderate to severe and more often severe for the migraine phenotype (MP; 260/328 [79.3%] of cases) than for the tension‐type phenotype (TTP). Precipitating factors were the following: stressful life events, 67/328 (20.4%); upper respiratory infection or flu‐like illness, 33/328 (10.1%); and extracranial surgery, 5/328 (1.5%). Exacerbating or aggravating factors similar to migraine triggers were more often reported with the MP than with the TTP in this sample. For the MP, vertigo or dizziness was reported by 19/260 (7.3%) and a visual aura by 21/260 (8.1%) with descriptions provided. The prognostic types were the following for all patients: persisting (refractory), 305/328 (93.0%); relapsing–remitting, 9/328 (2.7%); and remitting (self‐limited), 14/328 (4.3%). Conclusion NDPH is typically of moderate to severe intensity often with migraine features without obvious seasonal or other cyclical variation. Most cases are refractory. 3.6% have a thunderclap onset often with a good response to treatment.

show abstract

Section: Discussionsupporting

confidence: 78%

“…Rozen's retrospective NDPH series (3/74). 28 Robbins and Evans 25 and Jamali and Rozen 28 hypothesize that this thunderclap onset NDPH could be due to reversible cerebral vasoconstriction syndrome, 29 even though imaging studies were negative for cerebral vasospasm.…”

Section: Discussionmentioning

confidence: 99%

Clinical features of new daily persistent headache: A retrospective chart review of 328 cases

Evans

Turner

2021

Headache

View full text Add to dashboard Cite

show abstract

“…Repeated headache attacks can be triggered by the Valsalva maneuver or exertion in RCVS [20]. These factors also triggered headache attacks in our patient.…”

Section: Discussionsupporting

confidence: 53%

“…However, the longterm outcome of RCVS is usually excellent [5,13,14]. A number of studies have reported a low risk of recurrence for RCVS in the long term [20], which is usually due to re-exposure to RCVS triggers [5,15,21]. Nonetheless, some authors believe that the risk of recurrence is underestimated.…”

Section: Discussionmentioning

confidence: 99%

Reversible cerebral vasoconstriction syndrome (RCVS): an interesting case report

2021

View full text Add to dashboard Cite

Background Reversible Cerebral Vasoconstriction Syndrome is a condition of transient cerebral vascular spasms, which usually presents with recurrent thunderclap headaches and recovers within 3 months. Several probable triggers and underlying factors, such as sex hormones, vasoactive drugs, head trauma or surgery, and tumors, have been implicated. Case presentation In this paper, we present a 53-year-old woman with thunderclap headaches and normal lab tests who was radio-clinically diagnosed with reversible cerebral vasoconstriction syndrome and treated accordingly. Then, she experienced the recurrence of RCVS after about 2 years and headaches after 1 year in association with high blood pressure, high blood sugar, hypothyroidism, hyperlipidemia, and a urine metanephrine level of 5 times higher than the normal limit, suggesting a diagnosis of pheochromocytoma. After confirmation of the diagnosis with further imaging studies, surgical removal of the tumor resolved all the signs and symptoms. Conclusion Often underdiagnosed, pheochromocytoma could be an important condition associated with RCVS. It is important for clinicians to bear this diagnosis in mind while dealing with similar cases of recurrent thunderclap headaches.

show abstract

“…However, the long-term outcome of RCVS is usually excellent (6,13,14). A number of studies have reported a low risk of recurrence for RCVS in the long term (20), which is usually due to re-exposure to RCVS triggers (6,15,21). Nonetheless, some authors believe that the risk of recurrence is underestimated.…”

Section: Discussionmentioning

confidence: 99%

Mystery of Reversible Cerebral Vasoconstriction Syndrome (RCVS): An Interesting Case Report

Togha

Babaei

Ghelichi

2021

Preprint

View full text Add to dashboard Cite

BackgroundReversible Cerebral Vasoconstriction Syndrome is a condition of transient cerebral vascular spasms presenting with recurrent thunderclap headaches and recovery within three months. Several probable triggers and underlying factors, such as sex hormones, vasoactive drugs, head trauma or surgery, and tumors, have been implicated.Case presentationIn this paper, we present a 53-year-old woman with severe thunderclap headaches and normal lab tests who was radio-clinically diagnosed with reversible cerebral vasoconstriction syndrome and treated accordingly. Then, she experienced the recurrence of RCVS after about 2 years and headaches after one year in association with high blood pressure, high blood sugar, hypothyroidism, hyperlipidemia, and a urine metanephrine level of 5 times higher than the normal limit, suggesting a diagnosis of pheochromocytoma. After confirmation of the diagnosis with further imaging studies, surgical removal of the tumor resolved all the signs and symptoms. ConclusionOften underdiagnosed, pheochromocytoma could be an important condition associated with RCVS. It is important for clinicians to bear this diagnosis in mind while dealing with similar cases of recurrent thunderclap headaches.

show abstract

Narrative Review: Headaches After Reversible Cerebral Vasoconstriction Syndrome

Cited by 8 publications

References 18 publications

Clinical features of new daily persistent headache: A retrospective chart review of 328 cases

Clinical features of new daily persistent headache: A retrospective chart review of 328 cases

Reversible cerebral vasoconstriction syndrome (RCVS): an interesting case report

Mystery of Reversible Cerebral Vasoconstriction Syndrome (RCVS): An Interesting Case Report

Contact Info

Product

Resources

About