Basilar artery occlusion in migraine-like headache: a possible triggering effect of sumatriptan

Headache is a common symptom at the onset of acute ischemic cerebrovascular disease. Simultaneous development of migraine-like headache and stroke in the same patient makes it difficult to differentiate between migraine-induced stroke and migraine-like headache attributed to ischemic stroke. We repo...

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Bibliographic Details
Published in:Neurological sciences 2012-02, Vol.33 (1), p.125-128
Main Authors: Gazioglu, Sibel, Boz, Cavit, Ozmenoglu, Mehmet
Format: Article
Language:English
Subjects:
Adult
Angiography
Arteries
Brain stem
Brain Stem Infarctions - chemically induced
Brain Stem Infarctions - complications
Case Report
Case reports
Cerebral blood flow
Cerebral infarction
Cerebrovascular diseases
Computed tomography
Female
Headache
Headaches
Humans
Ischemia
Magnetic resonance imaging
Medicine
Medicine & Public Health
Migraine
Migraine Disorders - complications
Migraine Disorders - drug therapy
Neurology
Neuroradiology
Neurosciences
Neurosurgery
Psychiatry
Risk factors
Serotonin 5-HT1 Receptor Agonists - adverse effects
Serotonin 5-HT1 Receptor Agonists - therapeutic use
Stroke
sumatriptan
Sumatriptan - adverse effects
Sumatriptan - therapeutic use
Vertebrobasilar Insufficiency - chemically induced
Vertebrobasilar Insufficiency - complications
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Summary:Headache is a common symptom at the onset of acute ischemic cerebrovascular disease. Simultaneous development of migraine-like headache and stroke in the same patient makes it difficult to differentiate between migraine-induced stroke and migraine-like headache attributed to ischemic stroke. We report a case of a 34-year-old woman with no previous migraine history who presented with migraine-like headache, thought to be a first attack of migraine, and who developed brainstem infarction shortly after triptan administration. Magnetic resonance imaging revealed an acute pontine infarction, and CT angiography revealed occlusion of the basilar artery. A detailed etiological evaluation revealed no risk factor for ischemic stroke. We believe that the migraine-like headache was the first symptom of cerebral ischemia and that sumatriptan accelerated the development of the infarction. This case report emphasizes the importance of accurate diagnosis of migraine before using triptans. Secondary causes of migraine-like headache should be excluded, especially in patients with migraine-like headache for the first time.
ISSN:1590-1874
1590-3478
DOI:10.1007/s10072-011-0651-z