Patent foramen ovale in trigeminal autonomic cephalalgias and hemicrania continua: a non-specific pathophysiological occurrence?
Patent foramen ovale (PFO), a relatively common abnormality in adults, has been associated with migraine. Few studies also linked PFO with cluster headache (CH). To verify whether right-to-left shunt (RLS) is related to headaches other than migraine and CH, we used transcranial Doppler following microbubbles injection to detect shunts in 24 CH, 7 paroxysmal hemicrania (PH), one SUNCT, two hemicrania continua (HC) patients; and 34 matched controls. RLS was significantly more frequent in CH than in controls (54% vs. 25%, p=0.03), particularly above the age of 50. In the HC+PH+SUNCT group, RLS was found in 6 patients and in 2 controls (p=0.08). Smoking as well as the Epworth Sleepiness Scale correlated significantly with CH, smoking being more frequent in patients with RLS. PFO may be non-specifically related to trigeminal autonomic cephalalgias and HC. The headache phenotype in PFO patients probably depends on individual susceptibility to circulating trigger factors.
Amaral
Vanise
V
Hospital Quinta D'Or, Instituto D'Or de Pesquisa e Ensino, Rio de Janeiro, RJ, Brazil.
Freitas
Gabriel R de
GR
Rodrigues
Bruno C B
BC
Christoph
Daniel de H
Dde H
Pinho
Carlos A de
CA
Góes
Cristiana de Faria P
Cde F
Vincent
Maurice B
MB
D000328:Adult; D016022:Case-Control Studies; D005260:Female; D054092:Foramen Ovale, Patent / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D006261:Headache / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D051303:Trigeminal Autonomic Cephalalgias / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D017585:Ultrasonography, Doppler, Transcranial