Abstract
Background: Reversible cerebral vasoconstriction syndrome (RCVS) is a condition characterized by thunderclap headaches (TCHs), namely sudden and severe headaches that peak within few seconds. These headaches present diagnostic difficulties due to their diversity and low specificity, often leading to misdiagnoses and patient dissatisfaction.
Case presentation: Our case focused on a 52-year-old female who was initially misdiagnosed with migraines. Her journey from misdiagnosis to accurate identification of RCVS involved a series of key steps: initial misunderstanding, careful reconsideration, thorough re-examination, and finally conclusive diagnosis for treatment revision. This progression highlighted the challenges of distinguishing RCVS from other headache disorders, especially when the initial symptoms mimic more common conditions such as migraines. There was a significant shift in the patient's attitude throughout her entire treatment. Initially frustrated with the misdiagnosis, she eventually understood the complexities of diagnosing such atypical cases. It is worth noting that she expressed reluctance toward invasive treatments and favoured conservative management approaches.
Conclusion: This case emphasized the crucial role of timely diagnosis, detailed clinical evaluation and advanced imaging in RCVS diagnosis, highlighting the importance of effective doctor-patient communication in managing expectations and understanding patient preferences for treatment. By focusing on the unique features of RCVS and promoting open dialog with patients, healthcare professionals can improve diagnostic accuracy and patient satisfaction, thereby achieving better overall outcomes in managing this complex condition.