In short, the use of CCBs in RCVS is only for the prevention of thunderclap headache (TCH) recurrence. Since their purpose is to prevent TCH recurrence, they are often used when the patient is asymptomatic as well (i.e., even after the index TCH has resolved). They do have no impact on eventual clin...

I have been asked to answer this question, but I have never treated a patient for RCVS. It is an intriguing condition, and related to it, a question that I have had all along is how come it manifests itself with a so-called thunderclap headache? What is the underlying mechanism of the headache, know...

A number of these patients experience a dull, lingering headache, and I typically maintain them on verapamil, with or without magnesium, until their headache subsides. Afterward, I gradually taper off the medication over 7-10 days. I don't use it as a preventative measure as long as the patient is s...