title: Patent foramen ovale in patients with tension headache: is it as common as in migraineurs? An age- and sex-matched comparative study.
abstract: The association of patent foramen ovale (PFO) and atrial septal aneurysm (ASA) with migraine headache attack (MHA) has been clearly shown. The same findings have been recently demonstrated also in cluster headache. Although tension-type headaches (TTH) are the most common kind of headache, their association with these atrial septal abnormalities has never been studied before. The study was conducted to clarify whether there was a significant association between the presence of such atrial septal abnormalities and tension headache, when compared with migraineurs. One hundred consecutive patients with migraine and 100 age- and sex-matched subjects with TTH and 50 healthy volunteers with no headache were enrolled in the study and underwent a complete transesophageal echocardiographic study with contrast injections at rest and with the Valsalva maneuver. There was no significant difference between the age and the sex of the participants of the three groups. The overall prevalence of PFO was 23% in patients with TTH and that of large PFOs was only 11%. The 23% prevalence of PFO in patients with TTH was not statistically different from 16% found in our normal control group. Furthermore, we found a significantly higher prevalence of PFO in migraineurs (50%) when compared with patients with tension headache (p < 0.001). This was also true for the collective presence of large PFOs and ASAs (35%) (p < 0.001). Although atrial septal anomalies have an association with MHA, they do not have a significant association with TTH.
authors.affiliation: Department of Medicine (Cardiology), Namazee Hospital, Shiraz University of Medical Sciences, 71937-11351 Shiraz, Iran. moarefa@sums.ac.ir
authors.forename: Ali Reza
authors.initials: AR
authors.lastname: Moaref
authors.forename: Peyman
authors.initials: P
authors.lastname: Petramfar
authors.forename: Kamran
authors.initials: K
authors.lastname: Aghasadeghi
authors.forename: Mahmood
authors.initials: M
authors.lastname: Zamirian
authors.forename: Mohammad Bagher
authors.initials: MB
authors.lastname: Sharifkazemi
authors.forename: Shahed
authors.initials: S
authors.lastname: Rezaian
authors.forename: Sasan
authors.initials: S
authors.lastname: Afifi
authors.forename: Najaf
authors.initials: N
authors.lastname: Zare
authors.forename: Gholam Reza
authors.initials: GR
authors.lastname: Rezaian
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D015984:Causality; D002536:Cerebral Arteries / Q000503:physiopathology; D002560:Cerebrovascular Circulation / Q000502:physiology; D015897:Comorbidity; D004452:Echocardiography; D005260:Female; D054092:Foramen Ovale, Patent / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000453:epidemiology*; D015995:Prevalence; D017678:Sex Distribution; D018781:Tension-Type Headache / Q000453:epidemiology*; D014636:Valsalva Maneuver / Q000502:physiology; D055815:Young Adult