6.7.3.3 Persistent headache attributed to past reversible cerebral vasoconstriction syndrome (RCVS)

Identification: Sex/Age: Female, 38 years. History: Migraine without aura (diagnosed at age 25), irregular use of triptans. Relevant history: Previous episode of RCVS 4 months ago, confirmed by angiography, with spontaneous resolution after 3 weeks. History of Present Illness (HPI): Main symptom: Persistent headache for 3 months, started during the episode of RCVS. Pain characteristics: Location: Bilateral, fronto-occipital. Character: Continuous pressure, similar to a "tight band." Intensity: 5-6/10, with peaks of 8/10. Triggering factors: Physical exertion, emotional stress. Associated symptoms: Mild intermittent dizziness. Photophobia without phonophobia. Course: Persistence of headache after resolution of RCVS (confirmed by follow-up angiography). Physical/Neurological Examination: General: Preserved consciousness, normotensive (BP: 120/80 mmHg). Neurological: No motor or sensory deficits. Normal reflexes, no meningeal signs. Fundoscopy without papilledema. Complementary Exams: Magnetic Resonance Angiography (MRA): Normal (previous vasoconstriction resolved). Cranial Magnetic Resonance Imaging: No infarction, hemorrhage, or parenchymal lesions. Cerebrospinal Fluid (CSF): Normal pressure and biochemical analysis (excluding ICH or meningitis).