Sumatriptan Can Alleviate Headaches Due to Carotid Artery Dissection

Authors

  • Enrique C. Leira MD,

    1. From Souers Stroke Institute, Department of Neurology (Drs. Leira, Cruz-Flores, and Leacock), St. Louis (Mo)University School of Medicine.
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  • Salvador Cruz-Flores MD,

    1. From Souers Stroke Institute, Department of Neurology (Drs. Leira, Cruz-Flores, and Leacock), St. Louis (Mo)University School of Medicine.
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  • Rodney O. Leacock MD,

    1. From Souers Stroke Institute, Department of Neurology (Drs. Leira, Cruz-Flores, and Leacock), St. Louis (Mo)University School of Medicine.
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  • Saleem I. Abdulrauf MD

    1. Department of Neurosurgery (Dr. Abdulrauf), St. Louis (Mo) University School of Medicine.
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Address all correspondence to Dr. Enrique C. Leira, Souers Stroke Institute, Department of Neurology, 5-FDT, St. Louis University Hospital, 3635 Vista Avenue at Grand, St. Louis, MO 63110.

Abstract

Cluster headaches can be mimicked by a spontaneous carotid artery dissection. We report a 45-year-old man with a spontaneous carotid artery dissection whose unilateral headache responded to sumatriptan. An oral dose of 50 mg of sumatriptan relieved 90% of the pain after 2 hours. A second dose the next day achieved similar results within 4 hours. The diagnosis of dissection was made later by magnetic resonance angiogram and conventional angiography. This case illustrates that a positive response to a triptan can not be used to distinguish the first attack of cluster headache from a carotid artery dissection.

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