Closing Heart Foramen Reduces Associated Migraines

Transcatheter closure of patent foramen ovale (PFO) abolishes right-to-left shunting and reduces aura migraine headaches, according to a new study.

Researchers from the University of Bologna (Italy) examined factors responsible for migraine headache with aura in patients with PFO and assessed the mechanisms through which PFO closure leads to an improvement in such headaches.
Although the mechanisms that link right-to-left shunt to headache are unknown, comparison between PFO patients without migraine headache to those with a headache showed the latter had a higher prevalence of spontaneous and Valsalva-induced right-to-left shunt and a higher prevalence of spontaneous large shunt, both in transesophageal echocardiography and in transcranial Doppler studies.

Patients with headache also had more complex atrial septal anatomy and more often had an associated thrombophilia than patients without headache, the results indicated. Thirty-two of 35 patients experienced either complete resolution or significant improvement in their headaches after the procedure. None of the three patients who did not improve after the procedure had a residual shunt at transesophageal echocardiography. The results were reported in the April 2006 issue of the American Heart Journal.

"Paradoxical embolization of small-sized venous thrombus or platelet aggregate reasonably seems to be the leading mechanism precipitating migraine headache with aura in patients with a PFO,” wrote Dr. Alessandro Giardini and colleagues. "Transcatheter defect closure seems to be an effective and safe means to treat migraine headache with aura in patients with PFO.”



Related Links:
University of Bologna