Headache Attributed to Reversible Cerebral Vasoconstriction Syndrome (RCVS).

Area of Science:

• Neurology
• Vascular Neurology
• Neuroimaging

Background:

• Reversible cerebral vasoconstriction syndrome (RCVS) is increasingly recognized but poorly understood.
• RCVS is characterized by thunderclap headaches, neurological deficits, or seizures.
• It can be idiopathic or triggered by various factors.

Purpose of the Study:

• To clarify headache characteristics in RCVS.
• To examine the temporal association of angiographic findings.
• To explore RCVS association with SARS-CoV-2 and its presentation in children.

Main Methods:

• Systematic PRISMA search for published analytical or large descriptive observational studies.
• Review of data from 60 studies meeting specific criteria.
• Analysis of headache patterns, angiographic findings, and clinical presentations.

Main Results:

• Most RCVS patients experience typical thunderclap headaches; atypical presentations or absence of headache may be underrecognized.
• Headaches can persist after RCVS resolution.
• Vasoconstriction peaks within two weeks, resolving within three months; complications include stroke and hemorrhage.

Conclusions:

• RCVS has varied headache presentations, including atypical forms and persistent headaches.
• The association with SARS-CoV-2 requires further investigation.
• RCVS in children often occurs with underlying diseases; more large-scale studies are needed.