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Chronic CH -- treatment with warfarin
« on: Jan 11th, 2005, 7:59am »
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Arq Neuropsiquiatr. 2004 Dec;62(4):1090-1. Epub 2004 Dec 15.  
Remission of refractory chronic cluster headache after warfarin administrations: case report.
Souza JA, Moreira Filho PF, Jevoux Cda C, Martins GF, Pitombo AB.
Headache Investigation Sector, Universidade Federal Fluminense, Niteroi, RJ, Brazil.
Isolated reports of a possible positive effect of anti-coagulant drugs, among them heparin, warfarin and acenocumarol, in migraine prophylaxis are found in the literature. We report the case of a 37 years old man suffering from refractory chronic cluster headache that presented remission with the administration of warfarin for the treatment of deep venous thrombosis associated to arterial thrombosis. We did not found any case like that in the literature.
PMID: 15608975 [PubMed - in process]  
One case doesn't make a new treatment--but something to follow as more medical reports surface.....
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Bob Johnson


Re: Chronic CH -- treatment with warfarin
« Reply #1 on: Jan 11th, 2005, 9:03am »
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on Jan 11th, 2005, 7:59am, Bob_Johnson wrote:
Arq Neuropsiquiatr. 2004 Dec;62(4):1090-1. Epub 2004 Dec 15.  
One case doesn't make a new treatment--but something to follow as more medical reports surface.....

Your right that one case doesn't show much, but there have been more than one case.  
Another person on this board has reported the same thing with warfarin.  Also, DJ (the moderator of thisya board) had his clusters stop when he got surgery for moyamoya (constriction of arteries to the brain that causes stroke-like events).  
The warfarin effect is better studied for migraines - it also helps migraneurs, especially those with aura.  Migraneurs are at an increased risk of stroke, and I would bet that clusterheads are too, except that no one has been able to put together the statistics due to the 'rare' nature of the disease.  I'm guessing that micro-blood clots reduce blood flow and oxygen to the brain, and that makes the hypothalamus spaz (or the visual cortex freak in the case of aura).  
This also brings aspirin back into focus - not for aborting headaches (where it is useless) but for preventing when taken in low doses over time.  It does have certain risks (GI bleeding) but for many people, low dose aspirin benefits the heart and reduces the risk of stroke and maybe (hypothetically) turning down the head pain.  Its worth talking to your doc and doing more research to see what the known risks and benefits of low dose aspirin are.  
Diet should also be reconsidered - some diets have an anti-coagulant effect, while others are pro-thrombic.  Given the fact that diet can also affect inflammation and many other metabolic factors, I think it likely that diet can have some effect...  not that it will eliminate all clusters in all people, but if it could reduce the number of hits by 25% in a group of people, that would be something good.  
Some of the people that did this article on migraines also do very good cluster headache research.  I think we will hear more on this in the next few years.  
Neurol Sci. 2004 Oct;25 Suppl 3:S126-8.  
    Coagulation abnormalities in migraine and ischaemic cerebrovascular disease: a link between migraine and ischaemic stroke?
    Moschiano F, D'Amico D, Ciusani E, Erba N, Rigamonti A, Schieroni F, Bussone G.  L. Mandic Hospital, Via L. Mandic 1, Merate (LC), Italy.
    Migraine, particularly migraine with aura, is a risk factor for ischaemic stroke. The mechanisms underlying this association are obscure. One hypothesis is that shared risk factors may be the cause of this association. Over the last decade, studies have suggested an association between migraine and genetic abnormalities in coagulation factors which play an important role in stroke pathogenesis. Although the results of studies on various prothrombotic conditions are conflicting, findings suggest a higher frequency of some genetic abnormalities in migraine with aura patients. Thus, persistent hypercoagulability may explain the tendency for these patients to develop thromboembolic cerebrovascular events, especially when they are exposed to additional procoagulant stresses. Further studies on larger samples are required to test this hypothesis.
« Last Edit: Jan 11th, 2005, 9:08am by floridian » IP Logged
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