Recurrent thunderclap headaches from reversible cerebral vasoconstriction syndrome associated with duloxetine, xylometazoline and rhinitis medicamentosa.

KEY POINTS A 52-year-old woman presented to the emergency department with 2 episodes of thunderclap headaches separated by about 8 hours, both occurring during defecation. She had a history of chronic nasal congestion, asthma, chronic back pain, and low mood without other major depressive features