Closure of a patent foramen ovale: effective therapy of migraine and occipital stroke.
Whether stroke in a patient with migraine and patent foramen ovale (PFO) is due to PFO or migraine is difficult to decide. In a 33-year-old woman with migraine with aura, a visual field defect developed acutely. Neurological investigation revealed double vision when looking to the left and exaggerated patella tendon reflexes. Since then the patient complained about permanent visual impairment. CT- and MRI-scans of the brain showed a right occipital ischemic stroke. Intensive search for risk factors revealed cigarette smoking and chronic hypovolemia On transesophageal echocardiography an inter-atrial hypermobile septum and a PFO were detected. The patient underwent closure of the PFO by means of an Amplatzer PFO occluder nine weeks after the stroke. Since then she did not experience a further cerebrovascular event or migraine attack. This case shows that in a patient with PFO and migraine with aura, stroke may be attributable to migraine rather than to PFO. Occlusion of the PFO may reduce the frequency and intensity of migraine attacks.
Finsterer
Josef
J
Neurological Hospital Rosenhügel, Vienna, Austria. duarte@aonmail.at
Sommer
Oliver
O
Stiskal
Michael
M
Stöllberger
Claudia
C
Baumgartner
Helmut
H
D000328:Adult; D006328:Cardiac Catheterization; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000150:complications / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008881:Migraine Disorders / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D009778:Occipital Lobe / Q000473:pathology*; D020521:Stroke / Q000209:etiology / Q000473:pathology / Q000601:surgery*