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Introduction: Reversible Cerebral Vasoconstriction Syndrome (RCVS) is a rare condition of secondary headache to reversible multifocal narrowing of cerebral arteries, coursing with recurrent thunderclap-like pain, associated or not with focal neurological deficits and seizures. The mechanism is unknown, but an abnormality in control of cerebrovascular tonus triggered by a vasoconstrictor trigger is suggested. Diagnostic criteria is based on RCVS2, with high diagnostic accuracy. The aim is to report an unusual trigger cause for SVCR in a woman admitted in ER at Hospital Geral de Cuiabá. Case: CMP, 43-year-old, admitted at the cardiology ER, with an implantable cardioverter-defibrillator (ICD) due to asymmetric septal hypertrophic cardiomyopathy, referring after 2 sequential shocks of ICD, started a sudden, intense holocranial headache, worst in her life, associated to nausea and vomiting, without focal neurological deficits. Brain computed tomography and angiotomography of cranial vessels was performed, showing a thin layer of cortical subarachnoid hemorrhage (SAH) in right postcentral gyrus region, without aneurysmal dilations or others. Opioid analgesia was performed and Nimodipine was started as prophylaxis for cerebral vasospasm. On next day, presented a new episode of pain with the same characteristics, a new neuroimaging was acquired, maintaining the characteristics described. A skull arterial magnetic resonance angiography was requested for a better evaluation, however, because of ICD, it was unable to perform. RCVS2 was calculated, totaling 10 points, with high accuracy, diagnosing the pathology. Event prophylaxis initiated with Verapamil and Amitriptyline to pain and mood control and, during hospitalization, presented just one new episode of pain after measurements until telemetry is performed. Conclusion: SVCR is a rare entity and must be readily differentiated from malignant causes, such as aneurysmal SAH or others. Due to the recurrence of pain associated with the potential trigger and exclusion of other causes, diagnosis was established. RVCS2 scale was essential for the outcome in question. It´s being followed up at the headache and arrhythmology ambulatory, with a new imaging exam in three months, described in literature to verifying the reversal of initial findings.