{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T00:19:03Z","timestamp":1769127543835,"version":"3.49.0"},"reference-count":24,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,8,24]],"date-time":"2021-08-24T00:00:00Z","timestamp":1629763200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>In a recent Italian study, 30% of patients with reversible cerebral vasoconstriction syndrome (RCVS) presented without thunderclap headache (TCH), and tended to present more severe forms of RCVS than patients with TCH. We aimed to analyze the risk for complications of RCVS in patients with and without TCH at onset.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In a pooled cohort of 345 French patients with RCVS, we compared patients with and without TCH at onset regarding rates of neurological complications, and the functional outcome at 3\u00a0months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>As compared to the 281 patients with TCH at onset, the 64 patients without TCH had a higher risk for any neurological complication (61% vs. 24%, OR 4.9, 95% CI 2.8\u20138.7, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001). The association was strongest for cervical artery dissections (28% vs. 5%, OR 8.1, 95% CI 3.7\u201317.6, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001), followed by posterior reversible encephalopathy syndrome (17% vs. 3%, OR 7.1, 95% CI 2.7\u201318.4, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001), seizures (9% vs. 2.5%, OR 4.1, 95% CI 1.3\u201312.5, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.019), and subarachnoid hemorrhage (41% vs. 16%, OR 3.5, 95% CI 1.9\u20136.3, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001). In multivariable analysis, the risk for any neurological complication remained significantly elevated in the absence of TCH (OR 3.5, 95% CI 1.8\u20136.8, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001). The functional outcome was equal in both groups, with a modified Rankin scale score of 0\u20131 in \u226590% of patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Absence of TCH at onset might predict a higher risk of complications in RCVS. Our results warrant further multicentric studies to prove this finding.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.15064","type":"journal-article","created":{"date-parts":[[2021,8,13]],"date-time":"2021-08-13T08:42:17Z","timestamp":1628844137000},"page":"130-137","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Type of headache at onset and risk for complications in reversible cerebral vasoconstriction syndrome"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8056-8514","authenticated-orcid":false,"given":"Kristin Sophie","family":"Lange","sequence":"first","affiliation":[{"name":"Department of Neurology CHU Montpellier Hospital Gui de Chauliac Montpellier France"},{"name":"Center for Stroke Research Berlin (CSB) Charit\u00e9 \u2010 Universit\u00e4tsmedizin Berlin Germany"},{"name":"Department of Neurology I Charit\u00e9 Universit\u00e4tsmedizin Berlin Berlin 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