RCVS: The Rational Approach to Diagnosis and Treatment

Recruiting

Phase 4 Results N/A

Eligibility Criteria

Patients 18 years of age or greater meeting the following inclusion criteria adapted from Singhal and colleagues 2 will be included:
1. presentation consistent with RCVS :
- acute thunderclap/severe headache and
**supporting clinical features should prompt increased clinical suspicion (eg., potential medication trigger, recent pregnancy, migraine history)**
- evidence of beading/elevated velocities on imaging (Transcranial Doppler (TCD), angiogram, Computer Tomography Angiogram (CTA), MRA) and
- reversibility (by 90 days)-will not be required for inclusion but will be retrospectively adjudicated
Participants will be excluded from the study if they are:
- unable to consent AND no family present to consent, or
- have presence of aneurysmal, traumatic, or mesencephalic Subarachnoid Hemorrhage (SAH), or
- have presence of other supported diagnosis (eg., vasculitis- inflammatory lumbar puncture) or
- are currently pregnant or
- the use of nimodipine or verapamil is contraindicated for any reason (eg., allergy, breast feeding) or
- have limited TCD sonographic window
- stroke or ICH/SAH on presentation will not be a contraindication to inclusion in the trial **