Podcast 646: Thunderclap Headache, Think...RCVS?

<p><strong>Contributor:  Aaron Lessen, MD</strong></p> <p><strong>Educational Pearls:</strong></p> <ul> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">When evaluating a thunderclap headache, don’t forget RCVS!</span></li> <li style="list-style: none; display: inline"> <ul> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">RCVS:</span> <strong>reversible cerebral vasoconstriction syndrome</strong></li> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">Due to reversible spasms of cerebral blood vessels</span></li> </ul> </li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Can sometimes be seen on CTA or MRA, but often the imaging is normal and formal angiograms only occasionally show it</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">It can be caused by medications, intense physical activity, orgasm, and postpartum conditions, but the exact etiology is unknown</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Typically seen in females in their 40s</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Can result in bleeding, strokes, and seizures </span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">There is no good treatment, but stopping the suspected offending agent may help</span></li> </ul> <p><strong>References</strong></p> <p><span style="font-weight: 400;">Sattar A, Manousakis G, Jensen MB. Systematic review of reversible cerebral vasoconstriction syndrome.</span> <em><span style="font-weight: 400;">Expert Rev Cardiovasc Ther</span></em><span style="font-weight: 400;">. 2010;8(10):1417-1421. doi:10.1586/erc.10.124</span></p> <p><em><span style="font-weight: 400;">Summarized by John Spartz, MS3 | Edited by Erik Verzemnieks, MD</span></em></p> <p><br /> <br /></p>