title: Migraine with aura and silent brain infarcts lack of mediation of patent foramen ovale.
abstract: OBJECTIVE
  Population-based studies have shown a heightened prevalence of clinically silent brain infarcts in subjects who have migraine with aura (MA). We sought to determine whether this association could be confirmed in young patients with cryptogenic ischemic stroke, and explored the role of patent foramen ovale (PFO) as a potential underlying mechanism.
  
  
  METHODS
  Patients were selected from a registry of young patients consecutively treated for ischemic stroke in a tertiary university hospital among those without definite cause of stroke. Patients with PFO were matched for age and gender with patients with normal atrial septum. Migraine and MA were evaluated after patient selection and matching. Silent brain infarcts were independently evaluated on MRI.
  
  
  RESULTS
  We included 100 patients [60 men; mean age (SD), 44.8 years (8.3)], 50 patients with PFO. We found silent brain infarcts in 36 patients and MA in 13 patients. MA was more frequent in patients with silent brain infarcts than in patients without silent brain infarcts (25.0% vs. 6.3%; OR, 5; 95% CI, 1.4-17.6; P = 0.01). Traditional cardiovascular risk factors were not associated with silent brain infarcts. PFO was neither associated with MA (OR, 1.7; 95% CI, 0.5-5.3) nor silent brain infarcts (OR, 0.7; 95% CI, 0.3-1.5). The association of MA with silent brain infarcts was not altered after adjustment for PFO.
  
  
  CONCLUSIONS
  Findings suggest that silent brain infarcts in young patients with cryptogenic stroke is associated with MA. We found no evidence for a mediating effect of PFO on this association.
authors.affiliation: Department of Vascular Neurology, University Hospital, Toulouse, France.
authors.forename: L
authors.initials: L
authors.lastname: Calviere
authors.forename: P
authors.initials: P
authors.lastname: Tall
authors.forename: P
authors.initials: P
authors.lastname: Massabuau
authors.forename: F
authors.initials: F
authors.lastname: Bonneville
authors.forename: V
authors.initials: V
authors.lastname: Larrue
mesh_terms: D000328:Adult; D020520:Brain Infarction / Q000453:epidemiology*; D005260:Female; D054092:Foramen Ovale, Patent / Q000453:epidemiology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020325:Migraine with Aura / Q000453:epidemiology*; D015995:Prevalence
keywords: migraine with aura; patent foramen ovale; silent brain infarcts