Work

Reversible cerebral vasoconstriction syndrome presenting as thunderclap headache following high-altitude exposure and coca leaf tea consumption

Year: 2025

Type: article

Abstract: BACKGROUND: Reversible cerebral vasoconstriction syndrome (RCVS) is a rare cause of thunderclap headache, often triggered by environmental or pharmacologic stressors. METHODS: A 56-year-old women presented with thunderclap headache and focal neurological signs following high-altitude exposure and coca leaf tea consumption RESULTS: Neuroimaging demonstrated acute ischemic lesions in different arterial territories and severe narrowing of all medium-diameter intracranial arteries. She was started on dual antiplatelet therapy, intravenous fluids, and was instructed to remain in bed in a strictly flat position. Repeated MRI showed marked improvement of both ischemic lesions and the arterial vasospasm. CONCLUSION: High-altitude hypoxia and sympathomimetic alkaloids may synergistically precipitate RCVS. Awareness of traditional remedies and environmental exposures is essential in evaluating acute neurological syndromes in travelers.

Source: Journal of Stroke and Cerebrovascular Diseases

DOI: 10.1016/j.jstrokecerebrovasdis.2025.108506

Authors: Oscar H. Del Brutto, Eduardo J. Guzmán, Rafael Caputi, Denisse A. Rumbea, Víctor J. Del Brutto

Institutions: Universidad Espíritu Santo, Kennedy Clinic Hospital, University of Miami

Language: English

Topic: Neurological Complications and Syndromes

Subfield: Psychiatry and Mental health

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,170