Migraine therapy with heparin: pathophysiologic basis.

Abstract

SYNOPSISDuring headache‐free intervals, migraine patients had in their blood fewer basophilic leukocytes, which also contained less than a normal amount of heparin, and excreted less uroheparin than did controls. During migraine attacks the levels of basophils and of uroheparin rose but did not reach normal values.Sixty patients with severe vascular headaches (fifty‐three migraine and seven cluster) were treated with heparin by intravenous injections or aerosol inhalations. After repeated treatments, basophilic leukocytes and uroheparin levels rose to normal values and remained normal for varying periods, up to 14 months, after the end of therapy.Of the two treatment forms, aerosol therapy was the more effective. It reduced the migraine index of all but two of thirty‐three patients by an average of 86 (75–100) percent, whereas after intravenous therapy eighteen of twenty‐seven patients showed a better than 75 percent improvement.Three to 14 months after the end of therapy, seven patients were entirely free from migraine headaches and three more reported an average improvement of 90 percent.The role of endogenous heparin in migraine and the fate of injected and inhaled heparin are reviewed.