Correlation or causation: Untangling the relationship between patent foramen ovale and migraine

Adler, Eric; Love, Barry A.; Giovannone, Steve; Volpicelli, Frank; Goldman, Martin E.

doi:10.1007/s11886-007-0003-z

Cited by 6 publications

(4 citation statements)

References 57 publications

(47 reference statements)

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“…Right-to-left shunting through a PFO most commonly results from increased right atrial pressure, as occurs during the Valsalva maneuver or in the setting of severe pulmonary hypertension (Eisenmenger's syndrome), but anatomic factors such as prominent remnant eustachian valves can also contribute. 9 These factors were not apparent in this patient, but aortography demonstrated compression of the inferior vena cava by a secondary tumor, which could have had the effect of directing caval blood flow toward the PFO. Compression of this sort would increase the shunt, exposing the left side of the heart to toxic metabolites.…”

Section: Discussion Of Diagnosismentioning

confidence: 68%

Percutaneous closure of a patent foramen ovale in left-sided carcinoid heart disease

et al. 2007

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Section: Discussion Of Diagnosismentioning

confidence: 68%

Percutaneous closure of a patent foramen ovale in left-sided carcinoid heart disease

et al. 2007

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“…[ 6 ] Moreover, some vasoactive substances such as serotonin, which are normally degraded by the lung, bypass the lung to trigger brain arterioles and cause vasoconstriction, which induce hypoperfusion of the local brain tissue prone to cytotoxic edema. [ 7 ] Foong et al reported that the vasoconstriction of serotonin is more remarkable to arterioles than to main arteries such as the internal carotid and vertebral basilar artery. [ 8 ] The artery supplying the SCC are tiny and tortuous [ 9 ] ; hence, they are accessible to microemboli and sensitive to serotonin.…”

Section: Discussionmentioning

confidence: 99%

Is it coincidental or correlative between reversible splenial lesion syndrome and atrial septal defect?

Li¹,

Chen²,

Liu³

et al. 2020

Medicine

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Rationale: Reversible splenial lesion syndrome (RESLES) is a recently identified clinico-radiological syndrome, the etiology is miscellaneous. Atrial septal defect (ASD) as an underlying etiology for RESLES has not been reported. We first report a rare case of RESLES associated with ASD. The clinical, radiological, and ultrasonic profiles were presented and the pathophysiological mechanism was analyzed. Patient concerns: A 23-year-old man presented with headache, drowsiness, occasional paraphasia, and paroxysmal dry cough. Brain magnetic resonance imaging (MRI) on admission showed an ovoid isolated lesion in the splenium of corpus callosum, which exhibited hyperintensity on diffusion-weighted imaging and hypointensity on apparent diffusion coefficient, and completely disappeared on the follow-up MRI 14 days later. ASD was found by transthoracic echocardiography, Right-to-left shunts were detected on color Doppler of transesophageal echocardiography, and microemboli were captured by transcranial Doppler ultrasound. Diagnoses: According to his clinical history and imaging results, we confirmed the diagnosis of RESLES associated with ASD. Interventions: The patient was treated by oral aspirin and lopidogrel sulfate to inhibit platelet aggregation. In addition, oral nimodipine to suppress vasoconstriction. Outcomes: After 14 days treatment, all the symptoms presenting on admission resolved completely. Subsequently, a repair surgery of ASD under thoracoscopy was successfully performed. Lessons: To our knowledge, this is the first reported case of ASD may be an underlying etiology for RESLES and need require an etiotropic treatment.

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“…The data for patients with CHD are similar to that reported in the PFO literature, where the incidence of MH also approaches 40% with a similar distribution pattern of aura to migraines without aura. 12,13 In assessing the role of intracardiac shunt in the pathogenesis of MH in adults with CHD, patients were divided into right-to-left, left-to-right, and no shunt groups. Although the prevalence was much higher than the control population for all 3 groups, there was no significant difference in the prevalence of MH among the groups with right-to-left (52%), left-to-right (44%), and no intracardiac shunt (40%) (p ϭ 0.12).…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Migraine Headaches in Patients With Congenital Heart Disease

Truong

Slavin

Kashani

et al. 2008

The American Journal of Cardiology

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The prevalence of migraine headaches (MH) is 12% in the general population and increases to 40% in patients with patent foramen ovale. This study evaluated the prevalence of MH in patients with congenital heart disease (CHD). Of 466 patients contacted from the UCLA Adult Congenital Heart Disease Center, 395 (85%) completed a questionnaire to determine the prevalence of MH. Patients were stratified by diagnosis of right-to-left, left-to-right, or no shunt. A group of 252 sex-matched patients with acquired cardiovascular disease served as controls. The prevalence of MH was 45% in adults with CHD compared to 11% in the controls (p <0.001). Of the 179 patients with MH, 143 (80%) had migraines with aura and 36 (20%) had migraines without aura versus 36% and 64% observed in the controls (p <0.001). The frequency of MH was 52% in the right-to-left shunt group, 44% in the left-to-right, and 38% in the no shunt group (p ‫؍‬ NS). In patients with a right-to-left shunt who underwent surgical repair, 47% had complete resolution of MH, whereas 76% experienced >50% reduction in headache days per month. In conclusion, the prevalence of MH in all groups of adults with CHD is 3 to 4 times more than a sex-matched control population, with increasing prevalence of MH in patients with no shunt, left-to-right, and right-to-left shunt. The higher than expected frequency of MH in patients with CHD without an intracardiac shunt, suggests additional mechanisms to explain the significant association with MH.

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Correlation or causation: Untangling the relationship between patent foramen ovale and migraine

Cited by 6 publications

References 57 publications

Percutaneous closure of a patent foramen ovale in left-sided carcinoid heart disease

Percutaneous closure of a patent foramen ovale in left-sided carcinoid heart disease

Is it coincidental or correlative between reversible splenial lesion syndrome and atrial septal defect?

Prevalence of Migraine Headaches in Patients With Congenital Heart Disease

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