Migraine and patent foramen ovale: state of the science.
Migraine is a prominent cause of recurrent pain, affecting 12% of the population. In several case series, approximately 50% of migraineurs with aura were found to have patent foramen ovale (PFO). The pathophysiological mechanism is speculated to be passage of microemboli and vasoactive chemicals through the PFO, thereby evading pulmonary filtration and triggering migraine symptoms. This article presents the results of retrospective and prospective research studies documenting the effects of PFO closure on migraine symptoms and presents emerging theories on possible pathologic mechanisms that may partially explain the increased risk of ischemic stroke in the migraine population. Finally, evidence-based recommendations are presented for health care providers for managing patients who have migraine and PFO.
Fuller
Cindy J
CJ
Department of Cardiovascular Scientific Development, Swedish Medical Center, 500 17th Avenue NE, Suite 303, Seattle, WA 98122, USA.
Jesurum
Jill T
JT
D002545:Brain Ischemia / Q000209:etiology / Q000517:prevention & control; D006328:Cardiac Catheterization; D015984:Causality; D015897:Comorbidity; D013181:Cortical Spreading Depression / Q000502:physiology; D017281:Cost of Illness; D017548:Echocardiography, Transesophageal; D055317:Evidence-Based Practice; D054092:Foramen Ovale, Patent / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D008881:Migraine Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D015539:Platelet Activation / Q000502:physiology; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D012008:Recurrence; D012189:Retrospective Studies; D020521:Stroke / Q000209:etiology / Q000517:prevention & control