Background. Migraine is a chronic neurovascular disease with high prevalence (12-15% of the population) and social significance [1]. Pathogenesis of migraine has not been clear. Some studies report an association between migraine and the presence of a patent foramen ovale (PFO) and right-to-left shunt [2, 3, 4].
Introduction. The objectives of this study were to clarify the prevalence and clinical characteristics of migraine, as well as the effect of endovascular PFO closure on the course of migraine in a cohort of patients who suffered ischemic stroke (IS) by paradoxical embolism due to PFO.
Material and methods. We examined 97 patients from 18 to 50 y.o. (average age 32.29 ± 2.19 years, women 70.8%) with IS due to PFO in The Research Center of Neurology since January 2018 until October 2023. All patients were assessed for migraine, characteristics of headaches and the impact of migraine on social adaptation. Endovascular surgery was performed in 61 patients. The data from a dynamic examination of 24 patients with migraine were assessed before and after PFO closure.
Results. Among a cohort of IS due to PFO patients, the prevalence of migraine was 39.2% (migraine with aura - 55%, migraine without aura - 45%), the ratio of women to men was 1.9:1. The frequency of headaches was 4 [1;7] days per month. Six months after PFO closure, patients with migraine showed a significant decrease in the frequency of headaches from 4 [2; 24] up to 2 [1;5] days per month (p=0.009); reduction in pain intensity from 7 [7; 9] to 3 [3; 7] points according to VAS (p=0.0001); reduction of disability from 20 [6; 89] to 17 [2; 26] points (p=0.019) according to the MIDAS.
Conclusion. The present study confirmed the high prevalence of migraine in the PFO cohort. PFO closure led to decrease in frequency and intensity of headaches and decrease of migraine’s impact on social adaptation.