Reversible cerebral vasoconstrictive syndrome

Reversible cerebral vasoconstrictive syndrome (RCVS) (AKA benign cerebral angiopathy or vasculitis):

severe H/A with paroxysmal onset, ± neurologic deficit, and string of beads appearance on angiography of cerebral vessels that usually clears in 1–3 months. > 50% report prior use of vasoconstrictive substances (cocaine, marijuana, nasal decongestants, ergot derivatives, SSRIs, interferon, nicotine patches) sometimes combined with binge drinking. May also occur post-partum.

Complications occurred in 24% including:

a) usually during the 1st week: SAH, ICH, seizures, RPLS

b) usually during the 2nd week: ischemic events (TIA, stroke)