Possible iatrogenic bilateral cerebral ischemic infarcts in a woman with vasculitis
© Springer-Verlag 2008
Received: 8 March 2008
Accepted: 25 March 2008
Published: 17 April 2008
Dihydroergotamine mesylate (DHE), an ergot alkaloid, is an effective therapy for migraine headache and is considered safe to be used for a broader range of headache types . It is a significantly less potent arterioconstrictor than ergotamine tartrate (ET), which makes it a potentially safer drug . However, it still has the potential to cause cerebrovascular events including cerebral hemorrhage, subarachnoid hemorrhage and ischemic strokes. These potential complications may be especially expected in certain clinical scenarios.
The patient was also taking oral contraceptives at the time of presentation. The etiology of her infarctions may be multifactorial, but the combined administration of DHE and sumatriptan in the setting of vasculitis may have significantly contributed to the outcome. DHE and sumatriptan, though effective and safe treatment options for different headache syndromes, can result in serious complications (like cerebral infarction) if given over a short period of time. Moreover, the consideration of this treatment should be discouraged when the diagnosis of vasculitis is a possibility.
Conflict of interest
- Saper JR, Silberstein S, Dodick D, Rapoport A (2006) DHE in the pharmacotherapy of migraine: potential for a larger role. Headache 46(Suppl 4):S212–S220PubMedView ArticleGoogle Scholar
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