The Link Between Migraine, Reversible Cerebral Vasoconstriction Syndrome and Cervical Artery Dissection

Abstract

Headache is the common thread of migraine, reversible cerebral vasoconstriction syndrome (RCVS) and cervical artery dissection (CeAD), three medical conditions that otherwise appear to be very different. However, epidemiological, clinical and genetic data suggest that these conditions share common and complex features and are, at least partly, linked. The purpose of this manuscript is to review existing evidence for an association between migraine, RCVS and CeAD and discuss the potential underlying mechanisms.

Reversible cerebral vasoconstriction syndrome in paediatric patients with systemic lupus erythematosus: implications for management

“…1,12 Some of these mechanisms have also been hypothesized in RCVS. [13][14][15] In conclusion we can assume that SLE, notably SLE flare-up as observed in our patients, or SLE drugs, may represent a particular risk factor for RCVS. The observation of a positive familial history for SLEfour affected relativesin Patient 1 and an abnormal short stature in Patient 2 might also suggest underlying predisposing factors for both SLE and RCVS.…”

“…Another mechanism involves autoimmune inflammation injury, mediated by autoantibody production, complement activation, increased permeability of the blood–brain barrier, intrathecal production of proinflammatory cytokines, and immune complexes . Some of these mechanisms have also been hypothesized in RCVS …”

The Typical Thunderclap Headache of Reversible Cerebral Vasoconstriction Syndrome and its Various Triggers

“…This association mainly affects middle‐aged woman with a history of migraine, and often manifests as isolated cervical and head pain. Underlying potential mechanisms are discussed in this issue . In practice, their frequent association points to the need for a systematic study of both cervical and intracranial arteries in the two conditions, and in any patient with TCH …”

“…It has to be strengthened that several disorders, notably cervical artery dissection but also cerebral venous thrombosis and intracranial hypotension, can also be associated with an RCVS (Table ).…”

Triptans for Migraine Patients With Vascular Risks: New Insights, New Options

“…RCVS has been associated with the use of triptans. 71 The recurrence rate of RCVS was reported to be 5% in a Taiwanese series, and none of the 9 recurrent cases were reported to be linked with triptan use. One case reported by Meschia involved a patient who developed RCVS after taking 23 sumatriptan 25 mg tablets and 31 Midrin (a combination of isometheptene, acetaminophen and dichloralphenazone) doses over 1 week.…”