Vasoconstriction Cerebral Reversible Syndrome is an Entity That Does Not Missed in the Emergency Rooms

Background: Call-Fleming syndrome, also called reversible cerebral vasoconstriction syndrome (RCVS), is a clinical-radiological pathology, characterized by sudden-onset headache (thunderclap headache) with or without neurological deficit, in relation to multisegmental cerebral arterial vasoconstriction with spontaneous resolution in the following months, becoming a diagnostic-therapeutic challenge in relation to its nosological counterparts.

Case presentation: We present the case of a woman admitted to the emergency department with thunderclap headache without neurological deficit neither documented precipitating factors, identifying a cortical subarachnoid hemorrhage non-aneurysmal on the left fronto-parietal lobe, with data suggestive of vasoconstriction and increased velocity of the left middle cerebral artery evidenced by transcranial color Doppler, secondary causes of cerebral vasoconstriction were ruled out, with resolution in the control image performed at 3 months, for which it was classified as RCVS.

Conclusions: In this case we demonstrate the importance of carrying out an approach to differential diagnoses.