title: Atrial septal defect closure and de novo migraine: Exclusive ticlopidine efficacy.
abstract: BACKGROUND
  De novo onset or aggravation of migraine has been observed after atrial septal defect closure (ASDC), whereas antiplatelet drugs, such as clopidogrel, used to prevent post-ASDC thromboembolic events, have been associated with migraine amelioration.
  
  
  METHODS
  We report the case of a woman who, after ASDC, experienced de novo severe migraine with aura. Whereas use of acetylsalicylic acid or clopidogrel had no effect, ticlopidine use was associated with migraine amelioration. Migraine relapsed after two ticlopidine dechallenges, and disappeared after drug rechallenges.
  
  
  CONCLUSIONS
  A ticlopidine trial could be proposed to patients with migraine which occurs or worsens immediately after ASDC and does not improve with clopidogrel.
authors.affiliation: Department of Preclinical and Clinical Pharmacology, Headache Centre, University of Florence and Careggi University Hospital, Viale Pieraccini 6, Florence, Italy. silvia.benemei@unifi.it
authors.forename: Silvia
authors.initials: S
authors.lastname: Benemei
authors.forename: Eleonora
authors.initials: E
authors.lastname: Rossi
authors.forename: Rossella
authors.initials: R
authors.lastname: Marcucci
authors.forename: Betti
authors.initials: B
authors.lastname: Giusti
authors.forename: Pierangelo
authors.initials: P
authors.lastname: Geppetti
mesh_terms: D000328:Adult; D013504:Cardiovascular Surgical Procedures / Q000009:adverse effects*; D005260:Female; D005343:Fibrinolytic Agents; D006344:Heart Septal Defects, Atrial; D006801:Humans; D008881:Migraine Disorders / Q000188:drug therapy / Q000209:etiology* / Q000517:prevention & control*; D019651:Plastic Surgery Procedures / Q000009:adverse effects*; D013988:Ticlopidine; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D013988:Ticlopidine