Erenumab in a patient with persistent headaches after subarachnoid hemorrhage: A case report of an effective treatment

Headache. 2025 Feb;65(2):373-376. doi: 10.1111/head.14884. Epub 2025 Jan 26.

Abstract

A patient with persistent refractory headaches from aneurysmal subarachnoid hemorrhage was treated with monthly erenumab injections, a monoclonal antibody to the calcitonin gene-related peptide (CGRP) receptor. These injections decreased the frequency and severity of the patient's debilitating headaches from daily to once or twice per month with positive improvement in function and quality of life. To our knowledge, this is the first reported case in the literature of a patient with persistent post-subarachnoid hemorrhage headache that was successfully treated with an antibody against the CGRP receptor. This case report highlights the role of CGRP in post-subarachnoid hemorrhage headaches and the potential role for CGRP pathway-based therapies as an effective treatment.

Keywords: calcitonin gene–related peptide; erenumab; headache; migraine; subarachnoid hemorrhage; trigeminovascular system.

Publication types

  • Case Reports

MeSH terms

  • Antibodies, Monoclonal, Humanized* / administration & dosage
  • Antibodies, Monoclonal, Humanized* / pharmacology
  • Calcitonin Gene-Related Peptide Receptor Antagonists* / administration & dosage
  • Calcitonin Gene-Related Peptide Receptor Antagonists* / pharmacology
  • Female
  • Headache Disorders / drug therapy
  • Headache Disorders / etiology
  • Humans
  • Middle Aged
  • Subarachnoid Hemorrhage* / complications
  • Subarachnoid Hemorrhage* / drug therapy
  • Treatment Outcome

Substances

  • erenumab
  • Antibodies, Monoclonal, Humanized
  • Calcitonin Gene-Related Peptide Receptor Antagonists