Fear the reaper: reversible cerebrovascular vasoconstriction syndrome after hot pepper ingestion

The Carolina Reaper pepper is one of the spiciest edible peppers in the world. While localized symptoms such as mouth burning, mouth numbness, and even vomiting are the main risks of eating these peppers, recent case reports have revealed more serious complications of these potent foods. A 15-year-old healthy male ingested a Carolina Reaper pepper on a dare. Two days later, he developed an acute headache during football practice and was subsequently diagnosed with an acute cerebellar infarct and reversible cerebrovascular vasoconstriction syndrome. Reversible cerebral vasoconstriction syndrome should be considered in patients who present with severe headache after ingestion of ultraspicy peppers, and early treatment of reversible cerebral vasoconstriction syndrome should be initiated in patients with severe headache after pepper ingestion.