Clinical and Imaging Findings in Cryptogenic Stroke Patients With and Without Patent Foramen Ovale

Lamy, Catherine; Giannesini, C.; Zuber, Mathieu; Arquizan, Caroline; Méder, Jean-François; Trystram, Denis; Coste, Joël; Mas, Jean‐Louis

doi:10.1161/hs0302.104543

Cited by 454 publications

(333 citation statements)

References 42 publications

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“…There are some reports that hypothesise microembolic phenomena during stroke [16,17] and MA [18−20]. The presence of PFO or atrial septal aneurysm has been well studied in recurrent cerebrovascular events (MAS) and the association between PFO and transient global amnesia (TGA) suggested that intermittent microemboli in the late vertebrobasilar vessels territory underlie at least some TGA cases.…”

Section: Discussionmentioning

confidence: 99%

High prevalence of patent foramen ovale in migraine with aura

Ferrarini¹,

Malferrari

Zucco³

et al. 2005

J Headache Pain

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IntroductionThe patent foramen ovale (PFO) is a residue of foetal circulation and is found to be patent in approximately 20%− 30% of the adult population. In these subjects there is an interatrial right-to-left (R-L) shunting when right atrial pressure exceeds the pressure present in the left atrium. The association between PFO and stroke and other neurological diseases has been well documented by both perspective and historical studies [1,2].Transoesophageal sonography represents the gold standard for the diagnosis and follow-up of patients suffering from neurological diseases possibly due to J Headache Pain (2005) 6:71-76 DOI 10.1007 High prevalence of patent foramen ovale in migraine with aura Abstract In this study we evaluated the presence of patent foramen ovale (PFO) in a cohort of 25 consecutive patients suffering from migraine with aura (MA) during an attack presenting to the emergency ward of an Italian hospital. Patients underwent brain magnetic resonance imaging (MRI) with contrast medium, routine coagulation tests, contrast transcranial echocolour-coded sonography (c-TCCS) and transoesophageal echocardiography (TEE). Of the enrolled patients, 88.7% showed a PFO according to the c-TCCS test, whereas only in 72% TEE confirmed the presence of PFO. This discordance could be due to the fact that c-TCCS is more sensitive even with shunts with minimal capacity also located in the pulmonary vasculature. After surgical treatment of the PFO, MA disappeared within two months. Also, the treatment with warfarin as well as with acetylsalicylic acid and flunarizine was able to dramatically reduce the frequency of migraine attacks. These data indicate a higher prevalence of PFO in MA vs. normal population (OR=2.92) and could suggest that the presence of arteriovenous (AV) shunts could represent a trigger for MA attacks as well as for stroke, but more studies are needed to confirm this preliminary hypothesis.

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Section: Discussionmentioning

confidence: 99%

High prevalence of patent foramen ovale in migraine with aura

Ferrarini¹,

Malferrari

Zucco³

et al. 2005

J Headache Pain

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“…9 Subsequently, 2 recent studies reported a 2-to 5-fold increased prevalence for migraine in PFO carriers. 10,11 The reason for this apparent association between PFO and migraine remains undefined. Small emboli or serotonin not metabolized in the lung were considered as possible causes.…”

Section: Migrainementioning

confidence: 99%

Contemporary Management of Patent Foramen Ovale

2003

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“…In fact, an association between stroke, PFO and migraine has been reported [5,18,19]. Along with stroke, however, migraine and particularly MA have been the focus of greater interest in studies on PFO.…”

Section: Discussionmentioning

confidence: 99%

Migraine, patent foramen ovale and migraine triggers

Tembl¹,

Lago²,

Sevilla³

et al. 2007

J Headache Pain

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Little information exists about a causal association between PFO and migraine. Some patients identify Valsalva-provoking activities (VPA) as migraine triggers. Therefore, we speculate about a pathogenic connection. The object of the study is to investigate the prevalence of right-to-left shunt (RLS) in a cohort of patients suffering migraine with aura (MA) and its possible association with migraine attacks triggered by VPA. We investigated the circumstances triggering the migraine attacks, in a consecutive series of 72 MA patients and in a series of migraine without aura age and gender-matched. The presence and extent of RLS was assessed by transcranial Doppler. Massive RLS appeared in 38.9% of MA and in 6.5% of migraine without aura ( p <0.001). MA patients identified at least one VPA as headache trigger in 45.8%. A trend was found between these triggering activities and massive RLS, both in MAgroup OR 2.7 [1.02–7.17] and in all migraine patients OR 2.5 [1.01–6.11]. According to our results, patients with migraine who have larger RLS tend to recognize activities that increase the extent of the shunt as a trigger of their migraine attacks.

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Clinical and Imaging Findings in Cryptogenic Stroke Patients With and Without Patent Foramen Ovale

Cited by 454 publications

References 42 publications

High prevalence of patent foramen ovale in migraine with aura

High prevalence of patent foramen ovale in migraine with aura

Contemporary Management of Patent Foramen Ovale

Migraine, patent foramen ovale and migraine triggers

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