Acute emergency care and planned second opinion are different episodes
The cost of emergency CT, monitoring, admission or stroke treatment is very different from the cost of a later German outpatient review. International cost planning should begin only after immediate dangerous causes of thunderclap headache have been addressed locally.
Existing imaging can reduce unnecessary repeat testing
Send original CT/CTA, MRI/MRA and any DSA as DICOM files. If image quality and timing are adequate, the German team may be able to review the evolution before deciding whether another vascular study is needed.
Repeat CTA or MRA may be a major diagnostic cost driver
Early vascular imaging can be normal in RCVS and follow-up imaging helps document reversibility. The quote therefore depends on how many imaging time points are already available and whether a new CTA, MRA or vessel-wall MRI is clinically justified.
Catheter DSA should not be assumed in every quote
Digital-subtraction angiography is more resource-intensive than CTA or MRA and is generally reserved for selected diagnostic or severe cases. Ask whether DSA is actually planned and whether the estimate includes angiography-suite, contrast, monitoring and observation costs.
The PACNS differential can expand the work-up
When primary CNS vasculitis remains a serious alternative diagnosis, additional CSF review, laboratory testing, vessel-wall imaging and interdisciplinary neurological assessment may be needed. The cost should reflect the real differential diagnosis rather than a generic headache consultation.
Complications change the treatment episode
Convexity subarachnoid hemorrhage, intracerebral hemorrhage, ischemic stroke, PRES, seizures or persistent neurological deficits can require inpatient neurology, stroke care, rehabilitation and additional imaging beyond uncomplicated RCVS follow-up.
Medication treatment is usually not the dominant cost
Calcium-channel blockers such as nimodipine are commonly used for symptoms, but the major international-patient cost drivers are specialist evaluation, imaging, possible admission and diagnostic uncertainty rather than the medication itself.
Charité provides individualized international estimates
Charité's international-patient pathway reviews records first and provides cost information according to the requested outpatient or inpatient episode. Hospital estimates should be obtained after the responsible clinical team has defined the diagnostic plan.
Send these records before asking for a quote
A complete timeline helps avoid pricing an unnecessary repeat work-up.
- All CT/CTA DICOM files
- MRI/MRA/MRV DICOM files
- Catheter angiography if performed
- Lumbar-puncture and laboratory results
- Emergency and neurology discharge summaries
- Headache onset and recurrence timeline
- Medication and vasoactive-substance list
- Pregnancy/postpartum information when relevant
- Records of stroke, hemorrhage, PRES or seizures
- Requested service: second opinion, repeat vascular imaging, PACNS differential or post-acute follow-up
Official sources
Last source-reviewed 2026-09-05. Cost procedures and published service fees can change, so confirm current terms directly with the provider before transferring money or booking travel.