Narrative Review: Headaches After Reversible Cerebral Vasoconstriction Syndrome

Yu Hsiang Ling, Shih Pin Chen*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

7 Scopus citations


Purpose of Review: Reversible cerebral vasoconstriction syndrome (RCVS) is a disorder with distinct features: recurrent thunderclap headaches with reversible vasoconstriction of intracranial arteries. Substantial studies regarding outcomes after RCVS were conducted, showing favorable functional outcomes in most patients despite the potentially life-threatening complications of RCVS, including ischemic stroke, intracranial hemorrhage, or convexity subarachnoid hemorrhage. However, patients may report headaches after the resolution of RCVS while relative studies were scarce. Recent Findings: Two prospective studies from different cohorts consistently revealed that RCVS recurred in at least 5% of patients. Patients with prior migraine history and patients whose thunderclap headaches are elicited by sexual activity or exertion are at higher risk for RCVS recurrence. On the other hand, several retrospective studies and case reports reported that chronic headaches are common in RCVS patients after the resolution of acute bouts. The chronic headaches after RCVS are sometimes disabling in certain patients. Summary: Headaches after RCVS are not uncommon but usually overseen. Medical attention and examinations are warranted in patient with RCVS who reported recurrence of thunderclap headaches or chronic headaches after RCVS.

Original languageEnglish
Article number74
JournalCurrent Pain and Headache Reports
Issue number12
StatePublished - 1 Dec 2020


  • Chronic headache
  • Persistent headache
  • Recurrence
  • Reversible cerebral vasoconstriction syndrome
  • Thunderclap headache


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