Management

There is no evidence based treatment for RCVS. Early recognition of the syndrome is important to manage symptoms.

• remove any precipitating or aggravating factors
  • patients should be advised to rest (some patients need bed rest in hospital for two weeks) and to avoid sexual activity, physical exertion, Valsalva manoeuvres, and other triggers for a few days to a few weeks (depending on the initial severity)
  • vasoactive drugs should be discontinued (avoided even after disease resolves)
    
    
• drug treatment to relieve vasospasm
  • nimodipine, verapamil and magnesium sulphate have been used (1,2)

Reference:

• (1) Ducros A. Reversible cerebral vasoconstriction syndrome. Lancet Neurol. 2012;11(10):906-17
• (2) Ducros A, Bousser MG. Thunderclap headache. BMJ. 2013;346:e8557