https://doi.org/10.4081/cc.2025.15786

Intraparenchymal cerebral hemorrhage in a patient undergoing treatment with galcanezumab: the importance of adequate blood pressure control

Vol. 35 No. 1 (2025)
Submitted: 26 May 2025
Accepted: 17 July 2025
Published: 5 September 2025
Intraparenchymal cerebral hemorrhage, galcanezumab, anti-CGRP monoclonal antibody, blood pressure hypertension
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Authors

Yan Tereshko
Clinical Neurology Unit, Department of Head, Neck and Neurosurgery; Stroke Unit, Department of Head, Neck and Neurosurgery, Udine University Hospital, Italy.
Antonio Taglialatela
antonio.taglialatela97@gmail.com
https://orcid.org/0009-0006-1025-2545
Clinical Neurology Unit, Department of Head, Neck and Neurosurgery, Udine University Hospital, Italy.
Iacopo Cancelli
Neurology Unit, Department of Head, Neck and Neurosurgery, Udine University Hospital, Italy.
Enrico Belgrado
Neurology Unit, Department of Head, Neck and Neurosurgery, Udine University Hospital, Italy.
Lorenzo Verriello
https://orcid.org/0000-0002-5301-8621
Neurology Unit, Department of Head, Neck and Neurosurgery, Udine University Hospital, Italy.
Giovanni Merlino
Stroke Unit, Department of Head, Neck and Neuroscience; Department of Medical Area, Udine University Hospital, Italy.
Mariarosaria Valente
Clinical Neurology Unit, Department of Head, Neck and Neurosurgery; Department of Medicine, Udine University Hospital, Italy.

Background: Calcitonin gene-related peptide (CGRP) is a neuropeptide involved in pain transmission and modulation, and implicated in migraine pathophysiology. Due to the vasodilatory action of CGRP, anti-CGRP drugs, while ameliorating migraine, may increase hypertension, a major risk factor for cerebrovascular diseases. Although most studies support the safety of this class of drugs, the use of anti-CGRP drugs in some individuals has been associated with elevated blood pressure.

Case Presentation: We report a case of a cerebral hemorrhage in a patient treated with an anti-CGRP monoclonal antibody and a poorly controlled blood pressure.

Discussion: Migraine is associated with increased cerebrovascular risk and hypertension, and anti-CGRP therapies could potentially contribute to acute hypertensive episodes, possibly increasing the risk of complications, including cerebral hemorrhage, in vulnerable individuals.

Conclusions: Limited evidence links anti-CGRP therapies to hypertension. Pending additional data, caution is recommended when prescribing these drugs, especially in patients with cardiovascular risk factors.

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How to Cite

1.
Tereshko Y, Taglialatela A, Cancelli I, Belgrado E, Verriello L, Merlino G, et al. Intraparenchymal cerebral hemorrhage in a patient undergoing treatment with galcanezumab: the importance of adequate blood pressure control. Confinia Cephalal [Internet]. 2025 Sep. 5 [cited 2025 Sep. 15];35(1). Available from: https://www.confiniacephalalgica.com/site/article/view/15786
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