The Headache of SAH Responds to Sumatriptan


  • Jay H. Rosenberg MD,

  • Stephen D. Silberstein MD

  • From the UCSD School of Medicine, La Jolla, CA (Dr. Rosenberg); and Jefferson Headache Center, Philadelphia, PA (Dr. Silberstein).

Address all correspondence to Dr. Stephen D. Silberstein, Director, Jefferson Headache Center, 111 South 11th Street, Gibbon Building, Suite 8130, Philadelphia, PA 19107.


We report the first case of the headache of subarachnoid hemorrhage (SAH) possibly responding to a triptan. Recent evidence suggests that triptans block transmission from the trigeminal nerve to second-order neurons in the trigeminal nucleus caudalis; thus, any meningeal nociceptive process would be aborted. The triptans and ergots are not specific for migraine, but for any process that activates trigeminal fibers, including migraine, cluster headache, SAH, and meningitis. The failure to respond in the reported cases of meningitis may be due to sensitization.