Reversible cerebral vasoconstriction syndrome (RCVS) is characterised by severe headache and is associated with reversible segmental vasoconstriction of cerebral arteries. Conditions associated with RCVS are commonly pregnancy with or without pre-eclampsia, neurological procedures, head trauma. Thunderclap headache is the chief clinical presentation. Visual disturbances and focal neurological deficits are also frequently encountered. Posterior reversible encephalopathy syndrome and RCVS are often overlapping and hence most cases of RCVS are diagnosed late. We reported a young primigravida who had no comorbidities presenting to the ER with elevated blood pressure and generalised tonic and clonic seizures. Post-delivery her headache persisted and clinically her neurological status started deteriorating. Later she was diagnosed as RCVS. Treatment is based on expert opinion. Nimodipine, nifedipine or verapamil have been used in most patients
