Patients with acenocoumarol treatment and migraine

Objective.-The aim of our study was to investigate the possible effect of a cenocoumarol, which is indicated for nonneurological disease, on headache. Background.-It has been suggested that anticoagulation can have beneficial effects in the control of migraine attacks, Methods.-Four hundred randomized patients on oral anticoagulant therapy wer e asked to complete a questionnaire regarding their headaches, Results.-Headache was present before or during oral anticoagulation in 166 (66 migraineurs and 100 nonmigraineurs) of 326 respondents. The major findi ng was that oral anticoagulation produced improvement in 63% of patients wi th migraine versus 38% of patients with nonmigranous headache. Improvement was related to the severity of migraine but not to age. Conclusions.-Oral anticoagulant therapy can improve migraine. The way in wh ich anticoagulant therapy acts on migraine is unknown, but potential mechan isms include its effect on platelet aggregability and pharmacological effec ts such as suppression of enhanced nitric oxide.