clinical features
Last reviewed 01/2018
clinical features
The condition is usually acute and self-limiting without new symptoms after 1 month. RCVS may present as thunderclap headache (TCH) in isolation or TCH with associated neurologic symptoms (1).
Headaches remain the main and often the only manifestation in these patients
- presents with acute headaches - thunderclap headaches
- pain may last for few minutes to few hours
- typically bilateral (but can be unilateral) with posterior onset followed by diffuse pain
- screaming, crying, agitation, confusion and collapse are common due to the severity of the pain
- nausea, vomiting, photophobia, and phonophobia is seen frequently
- multiple episodes of thunderclap headaches are seen which recur every day or so for a few days to four weeks (but a single attack is also possible)
- between exacerbations the patient may complain of a persistent moderate headache (1,2)
In about third of patients, a surge in blood pressure can be observed during acute headaches (2)
Other associated symptoms include:
- neck pain - think of cervical artery dissection
- focal deficits
- transient -
- occurs in slightly more than 10% of patients
- last from 1 min to 4 h
- frequently visual, but sensory, dysphasic, or motor deficits can also occur
- persistent seizures
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