Recurrent Thunderclap Headaches

  • Nicholas F. Brown
  • Martin M. Brown


Reversible cerebral vasoconstriction syndrome (RCVS) is a transient disturbance in cerebral vascular tone with subsequent multifocal segmental intracerebral arterial constriction and dilation. It typically presents with recurrent thunderclap headaches, and with focal neurological deficits if cerebral infarction has occurred. Cerebral angiography demonstrates multifocal segmental narrowing and dilatation which normalises within 3 months. Differentiation from primary CNS angiitis can be made clinically, and from aneurysmal subarachnoid haemorrhage radiologically. Management includes enquiring about and discontinuing any potential precipitant. commencement of calcium channel blockers may be beneficial. Prognosis is favourable, but dependent on the extent of cerebral infarction.


Vasoconstriction Vasopasm Headache Thunderclap headache Angiography Cerebral haemorrhage Cerebral infarction Subarachnoid haemorrhage 


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Copyright information

© Springer-Verlag London 2015

Authors and Affiliations

  1. 1.Department of NeurologyRoyal Free Hospital, LondonLondonUK
  2. 2.Brain Repair & RehabilitationUCL Institute of Neurology, University College London, The National Hospital for Neurology and NeurosurgeryLondonUK

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