Diagnostic Value of Thunderclap Headache and Convexal Subarachnoid Hemorrhage for Reversible Cerebral Vasoconstriction Syndrome: A Case Report

Reversible cerebral vasoconstriction syndrome (RCVS) is an underdiabmosed cause of convexal suharachnoid hemorrhage, characterized by thunderclap headache associated with focal and segmental intracranial vasoconstriction. It can appear complications such as intracerebral hemorrhage, seizures, posterior reversible leukoencephalopathy, or ischemic stroke. Our objective is to present the case of a 51-year-old woman with an RCVS diagnosis, who had a normal digital subtraction angiography at the illness onset. We highlight the high diagnostic value of thunderclap headache and convexal subarachnoid hemorrhage. We also highlight the importance of repeating the angiographic studies in the second week when there is strong diagnostic suspicion.

Automated summary

RCVS is an underdiagnosed condition that can lead to subarachnoid hemorrhage, characterized by thunderclap headache and focal vasoconstriction. Repeating angiographic studies in the second week of suspicion is crucial for diagnosis and treatment.