Migraineurs with patent foramen ovale have larger right-to-left shunt despite similar atrial septal characteristics

J Headache Pain. 2007 Sep;8(4):209-16. doi: 10.1007/s10194-007-0396-5. Epub 2007 Sep 24.

Abstract

The objective of the study was to assess differences in proportion of large right-to-left shunt (RLS) and atrial septal characteristics between migraineurs and non-migraineurs referred for transcatheter closure of patent foramen ovale (PF0). This retrospective study took place in a large metropolitan medical centre. The patients were migraineurs with aura (n=52), migraineurs without aura (n=19) and non-migraineurs (n=149). RLS was evaluated before closure using bilateral power m-mode transcranial Doppler at rest and after calibrated, sustained Valsalva manoeuvre, and graded with a validated 0-5 scale. Intracardiac echocardiography was used to assess atrial septal characteristics. Migraineurs had a higher proportion of large RLS (Grade IV or V) than nonmigraineurs at rest and after calibrated Valsalva (rest, p=0.04; Valsalva, p=0.01). Atrial septal characteristics were similar between groups. Migraine is associated with larger RLS at rest and strain; however migraine status does not predict PFO characteristics.

MeSH terms

  • Adult
  • Aged
  • Atrial Septum / pathology
  • Atrial Septum / physiopathology*
  • Brain / blood supply
  • Brain / physiopathology
  • Cardiac Surgical Procedures
  • Cerebrovascular Circulation / physiology
  • Female
  • Foramen Ovale, Patent / complications*
  • Foramen Ovale, Patent / physiopathology*
  • Humans
  • Male
  • Middle Aged
  • Migraine Disorders / diagnostic imaging
  • Migraine Disorders / etiology*
  • Migraine Disorders / physiopathology*
  • Migraine with Aura / diagnostic imaging
  • Migraine with Aura / etiology
  • Migraine with Aura / physiopathology
  • Predictive Value of Tests
  • Regional Blood Flow / physiology*
  • Retrospective Studies
  • Sensitivity and Specificity
  • Treatment Outcome
  • Ultrasonography, Doppler, Transcranial
  • Valsalva Maneuver / physiology