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Reversible cerebral vasoconstriction syndrome: a rare cause of postpartum headache
  1. Kate S Wiles1,
  2. Ross Nortley2,
  3. Ata Siddiqui3,
  4. Paul Holmes2,
  5. Catherine Nelson-Piercy4
  1. 1Women's Health Academic Centre, St. Thomas’ Hospital, London, UK
  2. 2Department of Neurology, Guy's and St. Thomas’ NHS Foundation Trust, London, UK
  3. 3Department of Radiology, Guy's and St. Thomas’ NHS Foundation Trust, London, UK
  4. 4Department of Women's Health, Guy's and St. Thomas’ NHS Foundation Trust, London, UK
  1. Correspondence to Dr Kate S Wiles, Women's Health Academic Centre, 10th Floor North Wing, St. Thomas’ Hospital, Westminster Bridge Road, London SE1 7EH, UK; kate.wiles{at}


We describe two women presenting with severe postpartum headache associated with hypertension but with no other signs or investigation results to suggest pre-eclampsia. In one case, the headache was associated with atypical subarachnoid haemorrhage. The variable nature of the headache and the degree of associated hypertension raised the clinical suspicion of reversible cerebral vasoconstriction syndrome, confirmed on MR angiography. Both patients took nimodipine until the cerebral vasoconstriction had resolved radiologically.


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