Intracranial arteriopathies and RCVS
A discriminatory clinical tool
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Although the literature offers a number of clinical and radiologic approaches to the investigation of reversible cerebral vasoconstriction syndrome (RCVS), clinicians faced with new presentations of intracranial arteriopathy have no validated approach to assist them.1,2 The diagnostic criteria in the International Classification of Headache Disorders, 3rd edition (ICHD-3), provides a predominantly descriptive classification of RCVS categorizing definite and probable cases3 that provides little guidance in the setting of a new acute presentation. Distinguishing between RCVS and non-RCVS arteriopathies has important management implications particularly because steroids, often used in the management of non-RCVS arteriopathies, worsen the course and outcome of RCVS.4
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