Skip to main content
Advertisement
  • Neurology.org
  • Journals
    • Neurology
    • Clinical Practice
    • Genetics
    • Neuroimmunology & Neuroinflammation
  • Specialty Sites
    • COVID-19
    • Practice Current
    • Practice Buzz
    • Without Borders
    • Equity, Diversity and Inclusion
    • Innovations in Care Delivery
  • Collections
    • Topics A-Z
    • Residents & Fellows
    • Infographics
    • Patient Pages
    • Null Hypothesis
    • Translations
  • Podcast
  • CME
  • About
    • About the Journals
    • Contact Us
    • Editorial Board
  • Authors
    • Submit a Manuscript
    • Author Center

Advanced Search

Main menu

  • Neurology.org
  • Journals
    • Neurology
    • Clinical Practice
    • Genetics
    • Neuroimmunology & Neuroinflammation
  • Specialty Sites
    • COVID-19
    • Practice Current
    • Practice Buzz
    • Without Borders
    • Equity, Diversity and Inclusion
    • Innovations in Care Delivery
  • Collections
    • Topics A-Z
    • Residents & Fellows
    • Infographics
    • Patient Pages
    • Null Hypothesis
    • Translations
  • Podcast
  • CME
  • About
    • About the Journals
    • Contact Us
    • Editorial Board
  • Authors
    • Submit a Manuscript
    • Author Center
  • Home
  • Latest Articles
  • Current Issue
  • Past Issues
  • Residents & Fellows

User menu

  • Subscribe
  • My Alerts
  • Log in

Search

  • Advanced search
Neurology
Home
The most widely read and highly cited peer-reviewed neurology journal
  • Subscribe
  • My Alerts
  • Log in
Site Logo
  • Home
  • Latest Articles
  • Current Issue
  • Past Issues
  • Residents & Fellows

Share

April 14, 2015; 84 (15) Article

Recurrence of reversible cerebral vasoconstriction syndrome

A long-term follow-up study

Shih-Pin Chen, Jong-Ling Fuh, Jiing-Feng Lirng, Yen-Feng Wang, Shuu-Jiun Wang
First published March 18, 2015, DOI: https://doi.org/10.1212/WNL.0000000000001473
Shih-Pin Chen
From the Faculty of Medicine (S.-P.C., J.-L.F., J.-F.L., Y.-F.W., S.-J.W.), National Yang-Ming University School of Medicine, Taipei; Department of Neurology, Neurological Institute (S.-P.C., J.-L.F., Y.-F.W., S.-J.W.), and Department of Radiology (J.-F.L.), Taipei Veterans General Hospital, Taipei; Brain Research Center (S.-P.C., J.-L.F., Y.-F.W., S.-J.W.), Institute of Clinical Medicine (Y.-F.W.), and Institute of Brain Science (S.-J.W.), National Yang-Ming University, Taipei, Taiwan.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Jong-Ling Fuh
From the Faculty of Medicine (S.-P.C., J.-L.F., J.-F.L., Y.-F.W., S.-J.W.), National Yang-Ming University School of Medicine, Taipei; Department of Neurology, Neurological Institute (S.-P.C., J.-L.F., Y.-F.W., S.-J.W.), and Department of Radiology (J.-F.L.), Taipei Veterans General Hospital, Taipei; Brain Research Center (S.-P.C., J.-L.F., Y.-F.W., S.-J.W.), Institute of Clinical Medicine (Y.-F.W.), and Institute of Brain Science (S.-J.W.), National Yang-Ming University, Taipei, Taiwan.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Jiing-Feng Lirng
From the Faculty of Medicine (S.-P.C., J.-L.F., J.-F.L., Y.-F.W., S.-J.W.), National Yang-Ming University School of Medicine, Taipei; Department of Neurology, Neurological Institute (S.-P.C., J.-L.F., Y.-F.W., S.-J.W.), and Department of Radiology (J.-F.L.), Taipei Veterans General Hospital, Taipei; Brain Research Center (S.-P.C., J.-L.F., Y.-F.W., S.-J.W.), Institute of Clinical Medicine (Y.-F.W.), and Institute of Brain Science (S.-J.W.), National Yang-Ming University, Taipei, Taiwan.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Yen-Feng Wang
From the Faculty of Medicine (S.-P.C., J.-L.F., J.-F.L., Y.-F.W., S.-J.W.), National Yang-Ming University School of Medicine, Taipei; Department of Neurology, Neurological Institute (S.-P.C., J.-L.F., Y.-F.W., S.-J.W.), and Department of Radiology (J.-F.L.), Taipei Veterans General Hospital, Taipei; Brain Research Center (S.-P.C., J.-L.F., Y.-F.W., S.-J.W.), Institute of Clinical Medicine (Y.-F.W.), and Institute of Brain Science (S.-J.W.), National Yang-Ming University, Taipei, Taiwan.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Shuu-Jiun Wang
From the Faculty of Medicine (S.-P.C., J.-L.F., J.-F.L., Y.-F.W., S.-J.W.), National Yang-Ming University School of Medicine, Taipei; Department of Neurology, Neurological Institute (S.-P.C., J.-L.F., Y.-F.W., S.-J.W.), and Department of Radiology (J.-F.L.), Taipei Veterans General Hospital, Taipei; Brain Research Center (S.-P.C., J.-L.F., Y.-F.W., S.-J.W.), Institute of Clinical Medicine (Y.-F.W.), and Institute of Brain Science (S.-J.W.), National Yang-Ming University, Taipei, Taiwan.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Full PDF
Citation
Recurrence of reversible cerebral vasoconstriction syndrome
A long-term follow-up study
Shih-Pin Chen, Jong-Ling Fuh, Jiing-Feng Lirng, Yen-Feng Wang, Shuu-Jiun Wang
Neurology Apr 2015, 84 (15) 1552-1558; DOI: 10.1212/WNL.0000000000001473

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Permissions

Make Comment

See Comments

Downloads
454

Share

  • Article
  • Figures & Data
  • Info & Disclosures
  • CME Course
Loading

This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.

Abstract

Objective: We aimed to investigate whether reversible cerebral vasoconstriction syndrome (RCVS) could recur and to identify the potential predictors of recurrence in a large cohort of patients.

Methods: This study followed a cohort of 210 patients with RCVS in a hospital-based headache center from 2000 to 2012. All patients were regularly followed up by telephone after remission for RCVS and were particularly asked to return to our hospital immediately if they developed new acute, severe (i.e., thunderclap-like) headaches. Sequential neuroimaging studies were used to determine whether the patients had recurrent RCVS.

Results: One hundred sixty-eight patients were successfully followed. The response rate was 80.8%, and the mean follow-up period was 37.5 ± 24.4 (range 6–131) months. Eighteen patients (10.7%) returned to our hospital because of new thunderclap-like headaches, and 9 (5.4% of the total 168, and 50% of 18) were confirmed to have recurrent RCVS that occurred a mean 40.9 ± 27.2 (median 35, range 6–87) months after the initial bout. The incidence rate was 1.71 per 100 person-years (95% confidence interval 1.68–1.75). Having sexual activities as a trigger for thunderclap headaches (hazard ratio = 5.68, 95% confidence interval 1.11–29.15, p = 0.038) was an independent predictor of recurrent RCVS. None of the patients with recurrent RCVS developed cerebrovascular complications.

Conclusions: Recurrent RCVS should be considered when patients with RCVS develop new thunderclap-like headaches. Having sexual activities as a trigger for RCVS is a potential predictor of recurrent RCVS.

GLOSSARY

CI=
confidence interval;
ICHD-2=
International Classification of Headache Disorders, second edition;
ICHD-3-b=
International Classification of Headache Disorders, third edition (beta version);
LI=
Lindegaard index;
MRA=
magnetic resonance angiography;
RCVS=
reversible cerebral vasoconstriction syndrome;
TCCS=
transcranial color-coded sonography;
VMCA=
flow velocity of middle cerebral artery

Footnotes

  • Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • Supplemental data at Neurology.org

  • Received August 17, 2014.
  • Accepted in final form December 23, 2014.
  • © 2015 American Academy of Neurology
View Full Text

AAN Members

We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.

Google Safari Microsoft Edge Firefox

Click here to login

AAN Non-Member Subscribers

Click here to login

Purchase access

For assistance, please contact:
AAN Members (800) 879-1960 or (612) 928-6000 (International)
Non-AAN Member subscribers (800) 638-3030 or (301) 223-2300 option 3, select 1 (international)

Sign Up
Information on how to subscribe to Neurology and Neurology: Clinical Practice can be found here 

Purchase
Individual access to articles is available through the Add to Cart option on the article page.  Access for 1 day (from the computer you are currently using) is US$ 39.00.  Pay-per-view content is for the use of the payee only, and content may not be further distributed by print or electronic means.  The payee may view, download, and/or print the article for his/her personal, scholarly, research, and educational use.  Distributing copies (electronic or otherwise) of the article is not allowed.

Disputes & Debates: Rapid online correspondence

No comments have been published for this article.
Comment

NOTE: All authors' disclosures must be entered and current in our database before comments can be posted. Enter and update disclosures at http://submit.neurology.org. Exception: replies to comments concerning an article you originally authored do not require updated disclosures.

  • Stay timely. Submit only on articles published within 6 months of issue date.
  • Do not be redundant. Read any comments already posted on the article prior to submission.
  • 200 words maximum.
  • 5 references maximum. Reference 1 must be the article on which you are commenting.
  • 5 authors maximum. Exception: replies can include all original authors of the article.
  • Submitted comments are subject to editing and editor review prior to posting.

More guidelines and information on Disputes & Debates

Compose Comment

More information about text formats

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.
Author Information
NOTE: The first author must also be the corresponding author of the comment.
First or given name, e.g. 'Peter'.
Your last, or family, name, e.g. 'MacMoody'.
Your email address, e.g. higgs-boson@gmail.com
Your role and/or occupation, e.g. 'Orthopedic Surgeon'.
Your organization or institution (if applicable), e.g. 'Royal Free Hospital'.
Publishing Agreement
NOTE: All authors, besides the first/corresponding author, must complete a separate Disputes & Debates Submission Form and provide via email to the editorial office before comments can be posted.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

Vertical Tabs

You May Also be Interested in

Back to top
  • Article
    • Abstract
    • GLOSSARY
    • METHODS
    • RESULTS
    • DISCUSSION
    • AUTHOR CONTRIBUTIONS
    • STUDY FUNDING
    • DISCLOSURE
    • Footnotes
    • REFERENCES
  • Figures & Data
  • Info & Disclosures
  • CME Course

More Online

CME Course

Topics Discussed

  • Incidence studies
  • Secondary headache disorders
  • Other cerebrovascular disease/ Stroke

Alert Me

  • Alert me when eletters are published
Neurology: 96 (15)

Articles

  • Ahead of Print
  • Current Issue
  • Past Issues
  • Popular Articles
  • Translations

About

  • About the Journals
  • Ethics Policies
  • Editors & Editorial Board
  • Contact Us
  • Advertise

Submit

  • Author Center
  • Submit a Manuscript
  • Information for Reviewers
  • AAN Guidelines
  • Permissions

Subscribers

  • Subscribe
  • Activate a Subscription
  • Sign up for eAlerts
  • RSS Feed
Site Logo
  • Visit neurology Template on Facebook
  • Follow neurology Template on Twitter
  • Visit Neurology on YouTube
  • Neurology
  • Neurology: Clinical Practice
  • Neurology: Genetics
  • Neurology: Neuroimmunology & Neuroinflammation
  • AAN.com
  • AANnews
  • Continuum
  • Brain & Life
  • Neurology Today

Wolters Kluwer Logo

Neurology | Print ISSN:0028-3878
Online ISSN:1526-632X

© 2021 American Academy of Neurology

  • Privacy Policy
  • Feedback
  • Advertise