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

Jesurum, Jill T.; Fuller, Cindy J.; Velez, Carles A.; Spencer, Merrill P.; Krabill, Kimberly A.; Likosky, William; Gray, William A.; Olsen, John V.; Reisman, Mark

doi:10.1007/s10194-007-0396-5

Cited by 34 publications

(21 citation statements)

References 39 publications

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“…People with migraine with aura were more likely to have a PFO than migraineurs without aura. A small study of 25 consecutive patients with migraine with aura revealed a prevalence of PFO in 88.7%, according to the contrast transcranial echocolour-coded sonography and 72% according to the transoesophageal echocardiography [82]. A Swedish retrospective study in patients referred to transcatheter closure of PFO showed that migraineurs had a higher proportion of large right-left-shunts at rest and strain than non-migraineurs [83].…”

Section: Patent Foramen Ovale In Migraineursmentioning

confidence: 97%

From migraine to stroke

Katsarava¹,

Rabe²,

Diener³

2008

Intern Emerg Med

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An association between migraine and ischemic stroke has been observed for many years but the exact mechanisms by which migraine can lead to stroke are currently still under investigation. Migraine seems to affect neurovascular factors and substances that increase the risk of stroke during and in between migraine attacks. Ischemic stroke can occur as a complication of an attack of migraine with aura. Epidemiological studies suggest that vascular risk factors are increased in migraineurs, thus increasing the incidence of stroke. Another important issue is a patent foramen ovale (PFO), which is a well-known risk factor for stroke and which, on the other hand, seems to be more frequent in migraineurs than in people without. The purpose of this review is to summarize the current literature linking the two neurological diseases: migraine and stroke.

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Section: Patent Foramen Ovale In Migraineursmentioning

confidence: 97%

From migraine to stroke

Katsarava¹,

Rabe²,

Diener³

2008

Intern Emerg Med

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“…Although ASDs are most often associated with left-to-right shunting of blood, right-to-left shunting may occur during Valsalva or other activities increasing right atrial pressures. Studies on the effects of ASD repair and the prevalence and outcome of migraine have not reported a significant benefit [24,25].…”

Section: Cardiac Comorbiditymentioning

confidence: 99%

Chronic migraine: comorbidities, risk factors, and rehabilitation

2010

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Migraine is a serious illness with a spontaneous clinical evolution into a chronic form. In some episodic migraines, increase of crises frequency modifies the headache pattern in the chronic form, defined as chronic migraine (CM), with headache frequency of 15 days/month. One-year prevalence of CM includes around 2-4% of the general population. Migraine progression from episodic to chronic form is realized through a period of time involving several months or years, during which an increase of attack frequency occurs. Migraine shows a wide spectrum of comorbidities, including cardiocerebral, vascular, psychiatric, metabolic, neurologic as well as other pathologies. The single/multiple presence of such comorbidities represents a fixed factor in the process of chronicization into CM. Risk factors including medication overuse headache (MOH), obesity, and lifestyle cooperate in the evolution process to CM. MOH is the most severe complication of CM, and similarly to CM its appearance is gradual. Both CM and MOH show particular genetic background able to favor the appearance of chronicity and abuse. Rehabilitation consists of drug withdrawal procedures, re-prophylaxis through administration of innovative drugs, such as OnabotulinumtoxinA and/or topiramate, to avoid relapsing attacks, and behavioral strategies to minimize the role of risk factors. The initial relief step for drug abusers always relies in drug withdrawal. The feasible diagnostic setting for a CM tailored treatment based on the application of pharmacogenomics will allow us to predetermine the efficacy of single old and new drugs by avoiding abuse due to non-responsivity of the acute drug.

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“…The association is stronger between migraine with aura and PFO; the prevalence of PFO in patients with migraine with aura is higher (48%) compared to patients with migraine without aura (23%) and controls (20%) [65]. Also, patients with migraine tend to have greater right to left shunt in comparison to the normal population [68,69]. However, the association of PFO, migraine with aura and stroke is not conclusive.…”

Section: B1 Migrainementioning

confidence: 96%

Stroke in Women

Saini

Shuaib²

2008

PRC

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Stroke remains one of the leading causes of morbidity and mortality worldwide. Sexual differences in stroke have been recognized, though the mechanisms remain unclear. Women have a unique risk factor profile, especially so in the reproductively active age group. Exposure to oral contraceptives, hormone replacement therapy and a higher incidence of migraine and vasculitic disorders in women suggest that stroke would be common in women. Yet, the incidence of stroke remains higher in men across all ages, indicating a protective role of sex hormones. The differences in incidence and prevalence of stroke decreases as women age, confirming that hormones play a pivotal role in terms of normal physiology, disease and recovery. Recent evidence also points to sex based differences in response to therapy, in terms of acute management and prevention. Gender based differences in accessibility and provision of health care facilities add to the observed differences in terms of stroke outcome, though here women seem to fare worse than men. This review summarizes the observed sex differences in stroke, possible hormonal mechanisms that may explain the same and outlines recent patents and scope for future research in this field.

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

Cited by 34 publications

References 39 publications

From migraine to stroke

From migraine to stroke

Chronic migraine: comorbidities, risk factors, and rehabilitation

Stroke in Women

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