Reversible cerebral vasoconstriction syndrome in the postpartum period: A case report and review of the literature

Abstract

Reversible cerebral vasoconstriction syndrome (RCVS) is a rare phenomenon that can present in the postpartum period. We show the experience of a 35‐year‐old patient who presented with headache after an uncomplicated pregnancy and vaginal delivery. She was initially diagnosed with pre‐eclampsia, and subsequently with RCVS following discovery of multifocal vascular narrowing on magnetic resonance arteriography (MRA). Verapamil was initiated, and at 1 month there was improvement intracranially, but cervical vertebral arterial narrowing, likely dissection, was discovered. Verapamil was continued and aspirin was initiated. Follow‐up imaging 5 months postpartum demonstrated near‐complete resolution of previously noted abnormalities, which remained stable at reimaging at 10 months postpartum. In conclusion, the symptoms of RCVS can mimic or coexist with pre‐eclampsia. Early intracranial imaging such as MRA can permit timely diagnosis and facilitate appropriate management and follow‐up.