OBJECTIVES

To describe the main characteristics, radiological findings, etiologies, and the clinical course of patients with Reversible Cerebral Vasoconstriction Syndrome (RCVS) found in the literature.

METHODS

This systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and MetaAnalysis (PRISMA) guidelines, an exhaustive literature search was conducted using PubMed, EMBASE, LILACS, and CENTRAL. Case reports and case series describing RCVS were included, no publication date, language limitation, or sample size was established. To ascertain the quality assessment of case series and case reports, we used a tool created by the evidence-based practice center of Mayo Clinic.

RESULTS

The initial search retrieved 509 studies, 126 full-text articles were peer-reviewed, and 28 articles were describing 45 subjects were included. The vast majority of the reports were from the U.S and had female predominance (80.9%). All patients had a headache on the initial presentation, although only 57% had thunderclap headaches. A Computed Tomography (CT) scan was performed on 48% of the patients. Imaging results were diverse, with a tendency toward subarachnoid hemorrhage followed by mixed cases. The main course of treatment included calcium channel blockers (58%).

CONCLUSIONS

: Most of the cases reported in the literature are probably related to previous hypertensive patients, we established a trend in the imaging findings of subarachnoid hemorrhage and the combination of heart attack and stenosis. Currently, there are few high-quality studies to standardize the best approach for these patients, so knowing the leading causes associated with the most common clinical characteristics allows providing comprehensive health-care through a logical and rational sequence of treatments or therapies, reducing significant losses of human and economic resources, generating an appropriate therapeutic approach and restoring patient confidence.