Reversible Cerebral Vasoconstriction Syndrome

Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by the association of severe headaches and a segmental and multifocal string and beads appearance of the cerebral arteries. There may or may not be associated focal neurological symptoms and seizures. RCVS resolves spontaneously in 1–3 months.

RCVS may be primary or secondary (most common). Secondary causes include vasoactive substances (cannabis, SSRIs, nasal decongestants) and pregnancy.

RCVS is not as benign as it sounds. Complications can include intracranial hemorrhage (subarachnoid, parenchymal), seizures, reversible posterior leukoencephalopathy, transient ischemic attacks, and cerebral infarction.

Other vascular abnormalities have been noted in patients, including aneurysms and dissections.

References

Ducros A, Boukobza M, Porcher R, Sarov M, Valade D, Bousser MG. The clinical and radiological spectrum of reversible cerebral vasoconstriction syndrome. A prospective series of 67 patients. Brain. 2007 Dec;130(Pt 12):3091-101.