RCVS₂ Score for RCVS vs CNS Vasculitis
Differentiates reversible cerebral vasoconstriction syndrome (RCVS) from primary central nervous system vasculitis (PCNSV). Score ≥5 = RCVS likely (sensitivity 90%, specificity 99%).
Score interpretation
RCVS₂ score ≤1 — primary CNS vasculitis more likely
→ Neurology referral; brain biopsy considered for definitive PCNSV diagnosis; immunosuppression if PCNSV confirmed
RCVS₂ score 2–4 — indeterminate; clinical judgment required
→ MRI brain and angiography; neurologist review; serial imaging; avoid vasoconstrictive drugs
RCVS₂ score ≥5 — RCVS highly likely (sensitivity 90%, specificity 99%)
→ Avoid vasoconstrictive agents (triptans, ergots, vasopressors, sympathomimetics); calcium channel blockers (nimodipine, verapamil); analgesia; usually resolves within 3 months
Interpretation bands for the RCVS₂ Score. Apply clinical judgement and local guidance.
References
- Rocha EA et al. RCVS2 score and diagnostic approach for reversible cerebral vasoconstriction syndrome. Neurology. 2019;92(7):e639–e647.
Related
Curated clinical cross-links plus same-class fallbacks.
- Colchicine · Anti-inflammatory — Neutrophilic Dermatoses / Vasculitis
- Aspirin (Loading Dose) · Antiplatelet — ACS / Ischaemic Stroke
- Alteplase (tPA) · Thrombolytic — Ischaemic Stroke / Massive PE
- Edoxaban (AF Stroke Prevention / VTE) · Direct Factor Xa Inhibitor (DOAC)
- Clopidogrel (Stroke/TIA Secondary Prevention) · Antiplatelet (P2Y12 Inhibitor)
- Dabigatran (Stroke Prevention — AF) · Direct Oral Anticoagulant — Thrombin Inhibitor
- Acute Stroke / TIA Assessment · NICE NG128; RCP Stroke Guidelines 2023
- Status Epilepticus (Adults) · NICE CG137; ESEM guidelines; RCP Neurology Guidelines
- Suspected Subarachnoid Haemorrhage · NICE NG228; RCEM 2023; AHA/ASA 2023
- Adult Head Injury · NICE NG232 (2023)
- Bell's Palsy / Facial Nerve Palsy · ENT UK 2017; AAN
- Vertigo Workup · ENT UK; NICE CKS
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.