ADD-ONS / SCALES

RCVS2 score

David Goldemund M.D.
Updated on 21/07/2023, published on 20/01/2023

  • RCVS2 score uses simple clinical and imaging features for DDx between Reversible Cerebral Vasoconstriction Syndrome (RCVS) and primary angiitis of CNS (PACNS) (Rocha, 2019)
  • recurrent thunderclap headache (TCH) and single TCH combined with either normal neuroimaging, border zone infarcts, convexial SAH, or vasogenic edema have 100% positive predictive value for diagnosing RCVS or RCVS-spectrum disorder
    • if RCVS is likely, avoid steroids and vasoconstrictive medications (such as sumatriptan)
  • the presence of subcortical infarcts or abnormal CSF is specific for PACNS
recurrent or single thunderclap headache + 5
0
intracranial ICA involvement + -2
0
vasoconstrictive trigger identified + 3
0
sex female 1
male 0
subarachnoid (typically convexial) hemorrhage on imaging
1
+ 0
RCVSScore RCVS diagnosis
≤ 2 Negative
(specificity 100%, sensitivity 85%, PPV 100%, NPV 71%)
3-4 Equivocal
≥ 5 Positive
(specificity 99%, sensitivity 90%, PPV 96%, NPV 96%)

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RCVS2 score
link: https://www.stroke-manual.com/rcvs2-score/