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Narrative Review: Headaches After Reversible Cerebral Vasoconstriction Syndrome

Current Pain and Headache Reports volume 24, Article number: 74 (2020) Cite this article

Abstract

Purpose of Review

Reversible cerebral vasoconstriction syndrome (RCVS) is a disorder with distinct features: recurrent thunderclap headaches with reversible vasoconstriction of intracranial arteries. Substantial studies regarding outcomes after RCVS were conducted, showing favorable functional outcomes in most patients despite the potentially life-threatening complications of RCVS, including ischemic stroke, intracranial hemorrhage, or convexity subarachnoid hemorrhage. However, patients may report headaches after the resolution of RCVS while relative studies were scarce.

Recent Findings

Two prospective studies from different cohorts consistently revealed that RCVS recurred in at least 5% of patients. Patients with prior migraine history and patients whose thunderclap headaches are elicited by sexual activity or exertion are at higher risk for RCVS recurrence. On the other hand, several retrospective studies and case reports reported that chronic headaches are common in RCVS patients after the resolution of acute bouts. The chronic headaches after RCVS are sometimes disabling in certain patients.

Summary

Headaches after RCVS are not uncommon but usually overseen. Medical attention and examinations are warranted in patient with RCVS who reported recurrence of thunderclap headaches or chronic headaches after RCVS.

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Funding

This work was supported by the Brain Research Center, National Yang-Ming University from The Featured Areas Research Center Program within the framework of the Higher Education Sprout Project by the Ministry of Education (MOE) in Taiwan (to SPC); Ministry of Science and Technology of Taiwan [MOST-108-2314-B-010-022-MY3] (to SPC); and Taipei Veterans General Hospital [V109C-139] (to SPC). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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Affiliations

  1. Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan

    Yu-Hsiang Ling & Shih-Pin Chen

  2. Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan

    Yu-Hsiang Ling & Shih-Pin Chen

  3. Division of Translational Research, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan

    Shih-Pin Chen

  4. Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan

    Shih-Pin Chen

  5. Brain Research Center, National Yang-Ming University, Taipei, Taiwan

    Shih-Pin Chen

Authors
  1. Yu-Hsiang Ling
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  2. Shih-Pin Chen
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Correspondence to Shih-Pin Chen.

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Dr. Shih-Pin Chen and Yu-Hsiang Ling declare no conflict of interest.

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Ling, YH., Chen, SP. Narrative Review: Headaches After Reversible Cerebral Vasoconstriction Syndrome. Curr Pain Headache Rep 24, 74 (2020). https://doi.org/10.1007/s11916-020-00908-1

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  • DOI: https://doi.org/10.1007/s11916-020-00908-1

Keywords

  • Chronic headache
  • Persistent headache
  • Recurrence
  • Reversible cerebral vasoconstriction syndrome
  • Thunderclap headache