Retrospective, multi-center descriptive analysis of women aged 18-45 years diagnosed with RCVS by clinical and radiographic findings between January 2016 and March 2025 during peripartum (pregnancy or within 12 months postpartum). Patients were identified using Epic SlicerDicer and a radiology informatics database. Demographics, medical history, obstetric details, presenting symptoms, neuroimaging findings, hospital course, and clinical outcomes were collected.

Among 17 peripartum RCVS patients, median age of 29 years, 13 were multiparous, with a median gravida of 4. Preeclampsia was present in 35% of patients. The distribution of time of delivery to RCVS event demonstrated two peaks, with a cluster within the first two weeks (9 patients) and a second delayed cluster after 100 days (6 patients). Only 1 event occurred during pregnancy. All patients reported headaches on presentation.  

Focal neurological deficits were present on admission in 6 patients, blurred vision in 4 patients, and one patient had seizure on presentation. Neuroimaging findings included intracerebral hemorrhage (3/17, 2 of which were symptomatic), subarachnoid hemorrhage (6/17), and cerebral ischemia (4/17, 3 of which were symptomatic). Of all patients, including those with stroke complications, only 2 patients were discharged to acute rehab prior to home; 2 patients experienced ongoing focal neurological deficits at discharge and follow up.