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Prevalence and size of directly detected patent foramen ovale in migraine with aura.
Neurology. 2005 Nov 08; 65(9):1415-8.Neur

Abstract

BACKGROUND

Transcranial contrast Doppler studies have shown an increased prevalence of right-to-left shunts in patients with migraine with aura compared with controls. The anatomy and size of these right-to-left shunts have never been directly assessed.

METHODS

In a cross-sectional case-control study, the authors performed transesophageal contrast echocardiography in 93 consecutive patients with migraine with aura and 93 healthy controls.

RESULTS

A patent foramen ovale was present in 44 (47% [95% CI 37 to 58%]) patients with migraine with aura and 16 (17% [95% CI 10 to 26%]) control subjects (OR 4.56 [95% CI 1.97 to 10.57]; p < 0.001). A small shunt was equally prevalent in migraineurs (10% [95% CI 5 to 18%]) and controls (10% [95% CI 5 to 18%]), but a moderate-sized or large shunt was found more often in the migraine group (38% [95% CI 28 to 48%] vs 8% [95% CI 2 to 13%] in controls; p < 0.001). The presence of more than a small shunt increased the odds of having migraine with aura 7.78-fold (95% CI 2.53 to 29.30; p < 0.001). Besides patent foramen ovale prevalence and shunt size, no other echocardiographic differences were found between the study groups. Headache and baseline characteristics did not differ in migraine patients with and without shunt.

CONCLUSIONS

Nearly half of all patients with migraine with aura have a right-to-left shunt due to a patent foramen ovale. Shunt size is larger in migraineurs than controls. The clinical presentation of migraine is identical in patients with and without a patent foramen ovale.

Authors+Show Affiliations

Department of Cardiology, University Hospital, Inselspital, CH-3010 Bern, Switzerland.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16148260

Citation

Schwerzmann, M, et al. "Prevalence and Size of Directly Detected Patent Foramen Ovale in Migraine With Aura." Neurology, vol. 65, no. 9, 2005, pp. 1415-8.
Schwerzmann M, Nedeltchev K, Lagger F, et al. Prevalence and size of directly detected patent foramen ovale in migraine with aura. Neurology. 2005;65(9):1415-8.
Schwerzmann, M., Nedeltchev, K., Lagger, F., Mattle, H. P., Windecker, S., Meier, B., & Seiler, C. (2005). Prevalence and size of directly detected patent foramen ovale in migraine with aura. Neurology, 65(9), 1415-8.
Schwerzmann M, et al. Prevalence and Size of Directly Detected Patent Foramen Ovale in Migraine With Aura. Neurology. 2005 Nov 8;65(9):1415-8. PubMed PMID: 16148260.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevalence and size of directly detected patent foramen ovale in migraine with aura. AU - Schwerzmann,M, AU - Nedeltchev,K, AU - Lagger,F, AU - Mattle,H P, AU - Windecker,S, AU - Meier,B, AU - Seiler,C, Y1 - 2005/09/07/ PY - 2005/9/9/pubmed PY - 2006/4/13/medline PY - 2005/9/9/entrez SP - 1415 EP - 8 JF - Neurology JO - Neurology VL - 65 IS - 9 N2 - BACKGROUND: Transcranial contrast Doppler studies have shown an increased prevalence of right-to-left shunts in patients with migraine with aura compared with controls. The anatomy and size of these right-to-left shunts have never been directly assessed. METHODS: In a cross-sectional case-control study, the authors performed transesophageal contrast echocardiography in 93 consecutive patients with migraine with aura and 93 healthy controls. RESULTS: A patent foramen ovale was present in 44 (47% [95% CI 37 to 58%]) patients with migraine with aura and 16 (17% [95% CI 10 to 26%]) control subjects (OR 4.56 [95% CI 1.97 to 10.57]; p < 0.001). A small shunt was equally prevalent in migraineurs (10% [95% CI 5 to 18%]) and controls (10% [95% CI 5 to 18%]), but a moderate-sized or large shunt was found more often in the migraine group (38% [95% CI 28 to 48%] vs 8% [95% CI 2 to 13%] in controls; p < 0.001). The presence of more than a small shunt increased the odds of having migraine with aura 7.78-fold (95% CI 2.53 to 29.30; p < 0.001). Besides patent foramen ovale prevalence and shunt size, no other echocardiographic differences were found between the study groups. Headache and baseline characteristics did not differ in migraine patients with and without shunt. CONCLUSIONS: Nearly half of all patients with migraine with aura have a right-to-left shunt due to a patent foramen ovale. Shunt size is larger in migraineurs than controls. The clinical presentation of migraine is identical in patients with and without a patent foramen ovale. SN - 1526-632X UR - https://www.unboundmedicine.com/medline/citation/16148260/Prevalence_and_size_of_directly_detected_patent_foramen_ovale_in_migraine_with_aura_ L2 - http://www.neurology.org/cgi/pmidlookup?view=long&amp;pmid=16148260 DB - PRIME DP - Unbound Medicine ER -