Fatal cerebellar infarction in a migraine sufferer whilst receiving sumatriptan

Abstract

This is a case report of a 39-year-old man who suffered from a fatal cerebellar infarction whilst on sumatriptan therapy for an acute attack of migraine. Intracranial vasospasm is proposed as the likely causative mechanism and possible therapeutic intervention is highlighted.

Risk of ischemic complications related to the intensity of triptan and ergotamine use

“…Sumatriptan and the other second-generation serotonin 5HT 1B/1D -receptor agonists (triptans) have improved the quality of acute migraine treatment by providing a higher degree of efficacy and a more favorable side effect profile vs ergotamine. However, due to their 5HT 1 agonist activity, triptans can also cause coronary, craniovascular, and peripheral vasoconstriction possibly leading to serious complications such as myocardial infarction, 4-7 ischemic stroke, 8,9 and ischemic colitis, [10][11][12] mostly in patients with cardiovascular disease or risk factors. Therefore, the use of triptans, like ergotamine, is contraindicated in these patients.…”

Spontaneous splenic infarction associated with sumatriptan use

“…The major concern with the use of triptans has been the potential for vasoconstriction, especially of the coronary and intracerebral vessels. There are a few case reports of patients developing cardiovascular complications including myocardial infarction, arrhythmias and strokes secondary to use of triptans [1,2]. Isolated cases of mesenteric infarction [9] and a case of spinal cord infarction have also been reported [10].…”

Treatment of “Other” Stroke Etiologies

“…[369][370][371][372] Whether migraine prophylaxis might reduce the risk of recurrent stroke is unknown. [369][370][371][372] Whether migraine prophylaxis might reduce the risk of recurrent stroke is unknown.…”