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Migraine Study after Head Injury
Ongoing research into the damage caused by head injuries shows that many people have symptoms that last far longer than the standard recuperation time. Often, these side effects include migraines that may remain for days, weeks or even months.
Physicians at Holy Name Medical Center have been very successful in treating these severe headaches when conventional therapy has failed. They are at the forefront of migraine treatment, offering advanced therapies not given in all hospitals. They also conduct clinical trials, affording patients access to treatments not available to the general public.
Dr. James Charles, a neurologist and one of the leaders of Holy Name's Headache Treatment Program, conducted one such study, which showed extraordinary results in people who had suffered posttraumatic migraine headaches. Two months after treatment, patients received a 95 percent reduction in monthly headache days.
In the 6-month study, patients received an injection of erenumab, a human protein with antibodies that are used to block pain receptors. The medication is currently prescribed to prevent migraines. Only one out of the seven patients in the study needed a second dose of erenumab.
All the patients had suffered a significant head injury and their ensuing migraines did not respond to conventional treatment. One 26-year-old patient had fallen off a truck, hit his head and experienced daily migraines for 11 weeks. He didn't respond to physical or drug therapy and he couldn't work. Three weeks after receiving erenumab he returned to his job.
Another patient, a high school wrestler was unable to attend classes after being thrown to the mat and suffering a head injury. Five days after receiving erenumab he resumed classes.
Based on the exceptional results from his study, Dr. Charles is pushing for a larger clinical trial to be conducted at multiple sites.
Holy Name Study Shows Successful Migraine Treatment
Unrelenting migraines can stop people from performing the most ordinary of tasks – putting dishes away, sitting in a brightly-lit room – and instead forcing them to spend their energy trying to find relief from the pain and other symptoms. Many become socially incapacitated and ultimately seek help from a pyramid of doctors and try countless medications.
After searching, though, some of the fortunate ones find Dr. James Charles and Dr. Vincent Gallo at Holy Name Medical Center and receive treatment that is so successful they are back to living their lives, enjoying precious moments with loved ones and functioning in society again.
Dr. Charles, who is board-certified in neurology, clinical neurophysiology and headache medicine, and Dr. Vincent Gallo, an interventional radiologist who specializes in the treatment of migraines, use combination treatments to reset the brain circuitry and stop patients' pain. Included in the medication cocktail is a small dose of ketamine, an injectable medicine introduced as an anesthesia drug in the 1960's and was more recently found to be successful in the treatment of chronic pain.
"In this study, we looked at 10 patients we treated who had chronic migraines for one to two years, with daily headaches that did not respond to all known treatments," Dr. Charles said. "After treatment, all patients experienced substantially less headaches per month, and we're hoping this will generate a multicenter large scale study."
The study, published in Neurology Review, showed that all 10 patients were given infusion therapy, which included the drug ketamine, at Holy Name in an outpatient setting. Following their treatment, patients saw a reduction in headache pain of 71 percent, the study showed. Further, their headache frequency decreased by 88.6 percent after one month and 79.4 percent after two months.
"This shows that the treatment we are giving our patients is helping them tremendously," Dr. Gallo said. "These patients were really suffering and after treatment, they were nearly headache-free. For those who still got migraines after the treatment, the headaches were much less frequent and severe, and responded to oral medications."
Migraines are the seventh most debilitating disease in the world. They are caused when activated neurons in the brainstem continue to secrete pain messages to the brain, a process that shuts off in people without intractable migraines.
"This ongoing pain pathway becomes a debilitating runaway train that needs medications and procedures to stop," said Dr. Charles. He and Dr. Gallo have the expertise to know precisely what type and dose of medications is most effective in each patient.
"Although this is a small series of patients, the lack of adverse effects and impressive results should give credence to utilizing our protocol as treatment for this extremely debilitated, often desperate subset of headache patients," Dr. Charles said. "Our protocol persisted beyond the infusion period – which indicates a role for ketamine in this type of migraine pain."
