Reversible Cerebral Vasoconstriction Syndrome and Its Complications

Reversible cerebral vasospasm syndrome (RCVS) is a combination of acute severe (thunderclap) headache and angiographically detected multifocal spasm of the cerebral arteries reversible within 3 months. This review highlights the pathogenesis, clinical manifestations and course of RCVS, its complications (brain infarcts, hemorrhages, epileptic seizures), combination with posterior reversible encephalopathy syndrome and cervical artery dissection, neuroimaging and laboratory diagnostics, as well as differential diagnosis and treatment. The importance of a comprehensive clinical and neuroimaging assessment in the RCVS diagnosis is emphasized, since headache is not always thunderous and may be absent in patients with ischemic stroke caused by the spasm of the cerebral arteries.