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Migraine with aura and right-to-left shunt on transcranial Doppler: a case-control study.

Abstract

Right-to-left shunt (RLS), usually due to patent foramen ovale, is a well-established risk factor for ischemic stroke in young patients, while the role of migraine as an independent factor is still debated. We evaluated 44 patients suffering from migraine with aura, and compared them with 73 patients younger than 50 with focal cerebral ischemia, and 50 controls, asymptomatic for cerebrovascular disease, and without a history of migraine. All the subjects underwent bilateral transcranial Doppler with injection of contrast medium in an antecubital vein. The test was performed during normal ventilation and during Valsalva maneuver, recording both the middle cerebral arteries and the basilar artery. Criteria for diagnosing RLS was the presence of at least 3 microbubbles within 15 s from injection. Eighteen out of 44 migraine patients (41%) showed RLS, as opposed to 8 of 50 controls (16%) (p < 0.005). Twenty-six out of 73 patients with cerebral ischemia had RLS (35%). We conclude that the prevalence of RLS in patients with migraine with aura is significantly higher than in normal controls, and is similar to the prevalence of RLS in young patients with stroke. These findings could be helpful in understanding the relationship between migraine and stroke.

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  • Authors+Show Affiliations

    ,

    Department of Neurosciences and Neurorehabilitation, University of Genova, Italy.

    , , , , ,

    Source

    MeSH

    Adolescent
    Adult
    Brain Ischemia
    Case-Control Studies
    Cerebrovascular Circulation
    Female
    Heart Septal Defects, Atrial
    Humans
    Male
    Middle Aged
    Migraine Disorders
    Perceptual Disorders
    Ultrasonography, Doppler, Transcranial

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    9774749

    Citation

    Del Sette, M, et al. "Migraine With Aura and Right-to-left Shunt On Transcranial Doppler: a Case-control Study." Cerebrovascular Diseases (Basel, Switzerland), vol. 8, no. 6, 1998, pp. 327-30.
    Del Sette M, Angeli S, Leandri M, et al. Migraine with aura and right-to-left shunt on transcranial Doppler: a case-control study. Cerebrovasc Dis. 1998;8(6):327-30.
    Del Sette, M., Angeli, S., Leandri, M., Ferriero, G., Bruzzone, G. L., Finocchi, C., & Gandolfo, C. (1998). Migraine with aura and right-to-left shunt on transcranial Doppler: a case-control study. Cerebrovascular Diseases (Basel, Switzerland), 8(6), pp. 327-30.
    Del Sette M, et al. Migraine With Aura and Right-to-left Shunt On Transcranial Doppler: a Case-control Study. Cerebrovasc Dis. 1998;8(6):327-30. PubMed PMID: 9774749.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Migraine with aura and right-to-left shunt on transcranial Doppler: a case-control study. AU - Del Sette,M, AU - Angeli,S, AU - Leandri,M, AU - Ferriero,G, AU - Bruzzone,G L, AU - Finocchi,C, AU - Gandolfo,C, PY - 1998/10/17/pubmed PY - 2000/8/16/medline PY - 1998/10/17/entrez SP - 327 EP - 30 JF - Cerebrovascular diseases (Basel, Switzerland) JO - Cerebrovasc. Dis. VL - 8 IS - 6 N2 - Right-to-left shunt (RLS), usually due to patent foramen ovale, is a well-established risk factor for ischemic stroke in young patients, while the role of migraine as an independent factor is still debated. We evaluated 44 patients suffering from migraine with aura, and compared them with 73 patients younger than 50 with focal cerebral ischemia, and 50 controls, asymptomatic for cerebrovascular disease, and without a history of migraine. All the subjects underwent bilateral transcranial Doppler with injection of contrast medium in an antecubital vein. The test was performed during normal ventilation and during Valsalva maneuver, recording both the middle cerebral arteries and the basilar artery. Criteria for diagnosing RLS was the presence of at least 3 microbubbles within 15 s from injection. Eighteen out of 44 migraine patients (41%) showed RLS, as opposed to 8 of 50 controls (16%) (p < 0.005). Twenty-six out of 73 patients with cerebral ischemia had RLS (35%). We conclude that the prevalence of RLS in patients with migraine with aura is significantly higher than in normal controls, and is similar to the prevalence of RLS in young patients with stroke. These findings could be helpful in understanding the relationship between migraine and stroke. SN - 1015-9770 UR - https://www.unboundmedicine.com/medline/citation/9774749/full_citation L2 - https://www.karger.com?DOI=10.1159/000015875 DB - PRIME DP - Unbound Medicine ER -