TCT: PFO No Panacea for Migraine

WASHINGTON (MedPage Today) -- Percutaneous patent foramen ovale (PFO) closure did not significantly reduce the number of monthly migraine days compared with medical treatment, researchers reported here.
Source: MedPage Today Cardiovascular - Category: Cardiology Source Type: news

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CONCLUSION: The results do not suggest that a patent foramen ovale intervenes in the pathophysiology of the white matter lesions observed in patients with migraine. PMID: 32390130 [PubMed - in process]
Source: Revista de Neurologia - Category: Neurology Authors: Tags: Rev Neurol Source Type: research
Abstract Patent foramen ovale (PFO) is the most common anatomical cause of an interatrial shunt. It is usually asymptomatic but may cause paradoxical embolism, manifesting as stroke, myocardial infarction or visceral/peripheral ischaemia. PFO is a risk factor for stroke and may be associated with migraine with aura. New evidence suggests PFO closure reduces the risk of recurrent ischaemic stroke in a highly selected population of stroke survivors: those aged 60 years or younger with a cryptogenic stroke syndrome, a large right-to-left shunt, an atrial septal aneurysm and no evidence of atrial fibrillation. They be...
Source: Practical Neurology - Category: Neurology Authors: Tags: Pract Neurol Source Type: research
Abstract OBJECTIVE/BACKGROUND: Migraine is associated with ischemic stroke. Women are 3-fold as likely as men to have migraine, and high estrogen states increase the risk of migraine with aura (MWA), venous thromboembolism (VTE), and of stroke. We review the epidemiological and mechanistic evidence of the migraine-stroke relationship and its risk factors, with a focus on women and conditions that exclusively or predominantly affect them.  METHODS: We performed a search of MEDLINE/PubMed database, then a narrative review of the epidemiological evidence of the migraine-stroke relationship as...
Source: Headache - Category: Neurology Authors: Tags: Headache Source Type: research
A 67-year-old man was admitted to the emergency department with a 2-day history of headache, nausea, and left-hand weakness. On physical examination, his blood pressure was 145/70 mm Hg, heart rate 80 beats per minute, respiratory rate 20 breaths per minute, oxygen saturation 92%, and the grip strength on his left hand was grade 3. His medical history included migraines and hypertension. Magnetic resonance imaging showed right parietal infarct on diffusion-weighted imaging. Laboratory test results revealed that complete blood count, partial thromboplastin time, and prothrombin time were normal.
Source: Mayo Clinic Proceedings - Category: Internal Medicine Authors: Tags: Medical image Source Type: research
We report a case of SIH followed with brain infarction, with a distinct presentation from previous literature, suggesting a different mechanism. A 35 year-old had severe orthostatic headache, responsible for prolonged bed rest. One month later, he had acute left hemiparesis secondary to stroke and right posterior cerebral artery occlusion. Stroke MRI showed arguments for intracranial hypotension (thickened meninges). He was successfully treated with intravenous rtPA thrombolysis. Headache were resolved after an epidural blood patch. A patent foramen ovale was detected. Clinical features of this description were compar...
Source: Journal of Clinical Neuroscience - Category: Neuroscience Source Type: research
Conclusions: PFO closure is effective in alleviating migraine in the long term. This effect is more obvious when patients are younger than 45 years and RLS is large.
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Conditions:   Migraine;   Patent Foramen Ovale Interventions:   Device: GORE® CARDIOFORM;   Drug: Thienopyridine Sponsor:   W.L.Gore & Associates Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Abstract A 52-year-old woman experienced severe headache, confusion, nausea, dizziness, and diplopia for three days. Magnetic resonance imaging of the brain showed multiple acute and subacute infarcts suggestive of embolic events. Dermatological examination was notable for splinter hemorrhages and macular patches on the fingernails and feet, respectively. Further diagnostic imaging of the chest and abdomen revealed pulmonary emboli and an ovarian mass with omental deposits and splenic infarcts. Fine needle aspiration cytology and surgery confirmed a diagnosis of high grade serous adenocarcinoma of the ovary with c...
Source: Clin Med Res - Category: Research Authors: Tags: Clin Med Res Source Type: research
ConclusionPreclinical models suggest a key role for enhanced SD susceptibility and microembolization to explain both the occurrence of migraine attacks and the increased stroke risk in migraineurs. Therapeutic targeting of SD and microembolic events, or potential causes thereof, will be promising for treatment of aura and may also prevent ischemic infarction in vulnerable brains.
Source: The Journal of Headache and Pain - Category: Neurology Source Type: research
Patent foramen ovale (PFO) is present in 15% –30% of the general population and has been associated with various pathologic states, including cryptogenic stroke, platypnea–orthodeoxia syndrome, decompression sickness and migraine with auras. Transesophageal echocardiography (TEE) has a major role in the diagnostic evaluation of PFO, as wel l as in the post-procedural assessment after transcatheter closure. The goals of this article were to synthesize the echocardiographic transesophageal techniques required for accurate PFO diagnosis and careful anatomic assessment of its anatomic variants, to focus TEE indicat...
Source: Ultrasound in Medicine and Biology - Category: Radiology Authors: Tags: Review Source Type: research
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