Reversible cerebral vasoconstriction syndrome associated with a traditional Japanese training method under a waterfall named Takigyo: a case report

CASE: Takigyo is a traditional Japanese training method for psychosomatic conditions in which individuals meditate under a waterfall. A 55‐year‐old man presented with a mild headache and visual loss that occurred following Takigyo. On the day of admission, acute ischemic stroke was suspected based on brain magnetic resonance imaging examination. However, subsequent brain magnetic resonance imaging revealed reversible vasoconstriction of the cerebral diffuse segmental arteries. OUTCOME: We diagnosed reversible cerebral vasoconstriction syndrome caused by Takigyo on the basis of his clinical course and image findings. He was treated with nifedipine and his clinical condition improved without recurrence. CONCLUSION: We experienced a unique RCVS associated with Takigyo. It is important to accurately assess the etiology of headache with unusual circumstances and differential diagnosis including reversible cerebral vasoconstriction syndrome.