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Postpartum Thunderclap Headache 

Postpartum Thunderclap Headache
Postpartum Thunderclap Headache

M. Angela O’Neal

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date: 27 October 2021

An illustrative case of reversible cerebral vasoconstriction syndrome (RCVS) is presented. The clinical and radiographic features are reviewed. There is an overlap between RCVS and posterior reversible encephalopathy syndrome due to their shared pathophysiology related to endothelial injury. Furthermore, preeclampsia/eclampsia (PEE) is often associated with RCVS. Thunderclap headache is the most characteristic feature of the disorder. RCVS may also cause subarachnoid hemorrhage, typically located over the cerebral convexities; intracranial hemorrhage; and ischemic stroke. The diagnosis is made by seeing vasoconstriction on vessel imaging, either magnetic resonance angiography or computerized tomography angiography. There are several medications that can precipitate the condition by increasing sympathetic activity. Treatment is similar to that of PEE, with antihypertensives and magnesium. Calcium channel blockers are helpful symptomatic therapy for the headache.

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