A Case of Reversible Cerebral Vasoconstriction Syndrome Suspected of Migraine Affected by Psychological Factors

Abstract

A 46-year-old female patient was presented with sudden onset of severe headache, and her brain MRI and MRA to assess the cause of thunderclap headache did not reveal any significant findings. After eight days, she was admitted to the neurosurgery department at our hospital. She had thunderclap headache every day with emotional instability, and was referred to psychosomatic medicine suspected of migraine affected by psychological factors. MRA revealed multifocal constrictions of the cerebral arteries, and then, she was diagnosed with reversible cerebral vasoconstriction syndrome (RCVS). Her headache was cured after oral administration of lomerizine and she was discharged without any neurological complications. Conclusively, RCVS must be considered in patients with thunderclap headache as an important differential diagnosis.