A Case of Refractory Headache with Antiphospholipid Antibody Syndrome Improved by High-Intensity Warfarin Medication

Kyung-Hee Cho; Jun-Gyu Yang; Ji-Sun Kim; Sung-Wook Lee

doi:10.4078/jrd.2014.21.2.74

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Cho, Yang, Kim, and Lee: A Case of Refractory Headache with Antiphospholipid Antibody Syndrome Improved by High-Intensity Warfarin Medication

Case Report

J Rheum Dis 2014;21(2):74-76.

Published online: 31 October 2014

DOI: https://doi.org/10.4078/jrd.2014.21.2.74

A Case of Refractory Headache with Antiphospholipid Antibody Syndrome Improved by High-Intensity Warfarin Medication

Kyung-Hee Cho¹, Jun-Gyu Yang², Ji-Sun Kim¹, Sung-Wook Lee¹

¹Department of Neurology, Korea University College of Medicine, Seoul, Korea

²Department of Neurology, Keimyung University School of Medicine, Daegu, Korea

Corresponding to: Kyung-Hee Cho, Department of Neurology, Korea University College of Medicine, 73, Inchon-ro, Seongbuk-gu, Seoul 136-705, Korea. E-mail: kh.cho.neuro@gmail.com

Received 13 April 2013 Revised 12 June 2013 Accepted 17 June 2013

This is a Free Access article, which permits unrestricted non-commerical use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Antiphospholipid antibody syndrome (APS) is a coagulation disorder associated with antiphospholipid antibodies. Headache is common in APS patients and often un-responsive to analgesics. We report a case of refractory headache in a patient with APS, who was improved by high-intensity warfarin treatment. The mechanisms of the headache in patients with APS were presumed to be hyper-coagulability of microcirculation and thrombotic occlusion of the capillaries, which were associated with antiphospholipid antibodies. Therefore, high-intensity warfarin could be considered as one of the treatments for refractory headache in patients with APS.

Keywords: Antiphospholipid antibody syndrome, Headache, Warfarin

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Figure 1.

Brain MRI of the patient. (A, B) FLAIR and T-weighted image show cerebral infarction in the left insular cortex. (C) MR angiography reveals no stenotic lesion in intracranial arteries.

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