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Clinical features

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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clinical features

The condition is usually acute and self-limiting without new symptoms after 1 month. RCVS may present as thunderclap headache (TCH) in isolation or TCH with associated neurologic symptoms (1).

Headaches remain the main and often the only manifestation in these patients

  • presents with acute headaches - thunderclap headaches
  • pain may last for few minutes to few hours
  • typically bilateral (but can be unilateral) with posterior onset followed by diffuse pain
  • screaming, crying, agitation, confusion and collapse are common due to the severity of the pain
  • nausea, vomiting, photophobia, and phonophobia is seen frequently
  • multiple episodes of thunderclap headaches are seen which recur every day or so for a few days to four weeks (but a single attack is also possible)
  • between exacerbations the patient may complain of a persistent moderate headache (1,2)

In about third of patients, a surge in blood pressure can be observed during acute headaches (2)

Other associated symptoms include:

  • neck pain - think of cervical artery dissection
  • focal deficits
    • transient -
      • occurs in slightly more than 10% of patients
      • last from 1 min to 4 h
      • frequently visual, but sensory, dysphasic, or motor deficits can also occur
    • persistent seizures

Reference:


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The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

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