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Reversible cerebral vasoconstriction syndrome (RCVS): an interesting case report
Mansoureh Togha1,2, Mahsa Babaei3, Parvin Ganji Ghelichi4
1Neurology ward, Sina Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. togha1961@gmail.com.
The Journal of Headache and Pain
|April 7, 2021
Summary
Pheochromocytoma, a rare tumor, can cause recurrent thunderclap headaches by triggering Reversible Cerebral Vasoconstriction Syndrome (RCVS). Surgical removal of pheochromocytoma resolved RCVS symptoms in a patient, highlighting the importance of considering this diagnosis.
Area of Science:
- Neurology
- Endocrinology
- Oncology
Background:
- Reversible Cerebral Vasoconstriction Syndrome (RCVS) involves temporary cerebral artery spasms, typically causing thunderclap headaches and resolving within three months.
- Potential triggers for RCVS include hormonal factors, certain medications, head trauma, surgery, and tumors.
Observation:
- A 53-year-old woman presented with thunderclap headaches and a diagnosis of RCVS.
- She later experienced recurrent RCVS and headaches, associated with hypertension, hyperglycemia, hypothyroidism, hyperlipidemia, and elevated urine metanephrine levels, indicating pheochromocytoma.
Findings:
- Pheochromocytoma was confirmed through further imaging.
- Surgical resection of the pheochromocytoma led to the complete resolution of RCVS symptoms and headaches.
Implications:
- Pheochromocytoma is an underdiagnosed condition that can be associated with RCVS.
- Clinicians should consider pheochromocytoma in patients presenting with recurrent thunderclap headaches, especially those with RCVS.
