management

Last reviewed 01/2018

There is no evidence based treatment for RCVS. Early recognition of the syndrome is important to manage symptoms.

• remove any precipitating or aggravating factors
• patients should be advised to rest (some patients need bed rest in hospital for two weeks) and to avoid sexual activity, physical exertion, Valsalva manoeuvres, and other triggers for a few days to a few weeks (depending on the initial severity)
• vasoactive drugs should be discontinued (avoided even after disease resolves)
  
  
• drug treatment to relieve vasospasm
• nimodipine, verapamil and magnesium sulphate have been used (1,2)

Reference:

• (1) Ducros A. Reversible cerebral vasoconstriction syndrome. Lancet Neurol. 2012;11(10):906-17
• (2) Ducros A, Bousser MG. Thunderclap headache. BMJ. 2013;346:e8557