Serial testing of the ICHD-3 beta diagnostic criteria for probable reversible cerebral vasoconstriction syndrome: A prospective validation study

Lee, Mi Ji; Choi, Hae Woon; Choi, Hanna; Chung, Chin‐Sang

doi:10.1177/0333102417744361

Cited by 9 publications

(9 citation statements)

References 14 publications

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“…The criteria for probable RCVS, in which the diagnosis is suspected but cerebral angiography is normal, was assessed prospectively in a single-center study recruiting 99 adult patients with thunderclap headache from a headache clinic or the emergency department. 13 Patients were administered standardized questionnaires at the initial visit, 2 weeks, and 1 to 3 months after the first visit. Serial imaging was performed as well.…”

Section: Diagnosismentioning

confidence: 99%

Review on the Diagnosis and Treatment of Reversible Cerebral Vasoconstriction Syndrome in Children and Adolescents

2020

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Reversible cerebral vasoconstriction syndrome (RCVS) is a clinical–radiologic diagnosis that affects children and adolescents, but it is much more frequently reported in adults. Clinically, patients present with severe and commonly recurrent thunderclap headaches. Typical precipitating triggers include vasoactive substances, serotonergic agents, and the postpartum period. There may be associated neurologic complications at presentation or in the weeks following, such as convexity subarachnoid hemorrhage, stroke, cerebral edema, cervical artery dissection (CeAD), and seizures. Angiographically, the cerebral arteries demonstrate segmental vasoconstriction and dilation, although imaging early in the clinical course may be normal. Work-up is performed to exclude intracranial disorders such as vasculitis, subarachnoid hemorrhage due to ruptured aneurysm, meningitis, and intracranial venous sinus thrombosis. Within 1 month of initial symptom onset, clinical symptoms such as severe headache have ceased, and within 3 months, the cerebral vasoconstriction is much improved or resolved. Management involves avoidance of precipitating triggers and potentially short-term pharmacotherapy with calcium channel blockers for patients with associated neurologic complications. Steroids are not recommended and may worsen the clinical outcome. Prognosis is excellent in the large majority of patients, and only 5% of patients experience a recurrence of RCVS.

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Section: Diagnosismentioning

confidence: 99%

Review on the Diagnosis and Treatment of Reversible Cerebral Vasoconstriction Syndrome in Children and Adolescents

2020

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“…Reversible cerebral vasoconstriction syndrome (RCVS) is an under‐recognized neuroradiological disorder in which patients suffer abrupt severe headaches, often characterized as thunderclap headaches, and exhibit reversible cerebral vasoconstrictions . The clinical features of RCVS have been well characterized in studies involving, collectively, hundreds of patients worldwide . Patients with RCVS are at risk of severe complications including posterior reversible encephalopathy syndrome, ischemic stroke, and intracranial hemorrhage (including cortical subarachnoid, intracerebral, and subdural hemorrhage) .…”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3][4] The clinical features of RCVS have been well characterized in studies involving, collectively, hundreds of patients worldwide. [5][6][7][8][9][10][11][12][13] Patients with RCVS are at risk of severe complications including posterior reversible encephalopathy syndrome, ischemic stroke, and intracranial hemorrhage (including cortical subarachnoid, intracerebral, and subdural hemorrhage). [5][6][7][8][9][10]14 Sympathetic overactivity, 15 oxidative stress, 16 an impaired endothelial repair capacity, 17 and genetic predisposition 18 may contribute to the dysregulated vascular tone of cerebral arteries in RCVS, 4,19,20 though a definitive pathogenesis has not yet been delineated.…”

Section: Introductionmentioning

confidence: 99%

Influence of Climate on the Incidence of RCVS – A Retrospective Study From Taiwan

et al. 2019

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Background Cold weather is reportedly a precipitator of reversible cerebral vasoconstriction syndrome (RCVS) in a few cases. We systematically investigated whether meteorological factors correlate with the occurrence of RCVS. Methods We conducted a retrospective analysis of a cohort of patients diagnosed with RCVS or probable RCVS, based on International Classification of Headache Disorders, third edition (ICHD‐3) criteria, in a hospital‐based headache center from March 2005 to February 2014. Monthly averages of local weather data measured in Taipei were obtained from the Central Weather Bureau in Taiwan. Primary weather variables were compared with the number of monthly new‐onset cases of RCVS. Results We recruited 226 patients with established RCVS and 72 patients with probable RCVS during a 108‐month study period. Incidence of RCVS was higher in winter than summer months (3.3 persons/month [SD: 2.0] vs 2.1 persons/month [SD: 1.5], P = .013). The monthly incidence of RCVS correlated negatively with mean daily temperature (r = −0.231, P = .016) and average precipitation (r = −0.269, P = .005), but positively with barometric pressure (r = 0.274, P = .004). These 3 correlated meteorological factors together explained about 10% of the variance in RCVS monthly incidence (R2 = 0.095, P = .015). Conclusion RCVS was found to be more common in winter months and to be associated with weather variables in Taiwan. Further studies are needed to explore the underlying mechanisms of these associations.

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“…However, there is lack of direct evidence to support this speculation. RCVS often cannot be diagnosed initially, since an angiogram performed in the early stage of RCVS can be normal (22,33,55,56) or is further considered as probable RCVS based on the ICHD-3 criteria (1,27). Studies have also suggested that even without significant angiographic vasoconstrictions, recurrent thunderclap headaches were almost diagnostic of RCVS (26,(57)(58)(59).…”

Section: Introductionmentioning

confidence: 99%

Update on primary headache associated with sexual activity and primary thunderclap headache

Lin

Chen

2023

Cephalalgia

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Background This narrative review aims to provide an update on primary headache associated with sexual activity and primary thunderclap headache. Methods We conducted a literature search on PubMed with the keywords “headache associated with sexual activity”, “sexual headache”, “orgasmic cephalalgia”, and “coital cephalalgia” in addition to “thunderclap headache” to assess the appropriateness of all published articles in this review. Results Primary headache associated with sexual activity is a “primary” headache precipitated by sexual activity, which occurs as sexual excitement increases (progressive at onset), or manifests as an abrupt and intense headache upon orgasm (thunderclap at onset) or combines these above two features. Primary headache associated with sexual activity is diagnosed after a thorough investigation, including appropriate neuroimaging studies, to exclude life-threatening secondary causes such as subarachnoid hemorrhage. According to the criteria of the third edition of the International Classification of Headache Disorders, primary thunderclap headache is also a diagnosis by exclusion. The pathophysiology of primary headache associated with sexual activity and primary thunderclap headache remains incompletely understood. Treatment may not be necessary for all patients since some patients with primary headache associated with sexual activity and primary thunderclap headache have a self-limiting course. Conclusion A comprehensive neuroimaging study is needed for distinguishing primary headache associated with sexual activity or primary thunderclap headache from secondary causes. Primary headache associated with sexual activity and primary thunderclap headache are self-limited diseases and the prognoses are good, but some patients with primary headache associated with sexual activity may have a prolonged course.

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Serial testing of the ICHD-3 beta diagnostic criteria for probable reversible cerebral vasoconstriction syndrome: A prospective validation study

Cited by 9 publications

References 14 publications

Review on the Diagnosis and Treatment of Reversible Cerebral Vasoconstriction Syndrome in Children and Adolescents

Review on the Diagnosis and Treatment of Reversible Cerebral Vasoconstriction Syndrome in Children and Adolescents

Influence of Climate on the Incidence of RCVS – A Retrospective Study From Taiwan

Update on primary headache associated with sexual activity and primary thunderclap headache

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