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The Association of Patent Foramen Ovale and Migraine Headache

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Patent Foramen Ovale

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Abstract

Multiple observational studies have identified a link between patent foramen ovale (PFO) and migraine headache. PFO is found in 40 to 60 % of people who have migraine with aura compared to 20 to 30 % in the general adult population. It is hypothesized that migraine, especially migraine with aura or other transient neurologic deficits, may be triggered by chemicals that are ordinarily metabolized during passage through the lungs. However, the presence of a right-to-left shunt allows these chemicals to bypass metabolic alteration in the lungs and gain entry to the arterial circulation in a higher concentration so that upon reaching the brain, they stimulate receptors in susceptible individuals which produces the cerebral migraine phenomena. This hypothesis was derived after observations that PFO closure for other reasons, such as decompression sickness in divers or to prevent cryptogenic stroke, resulted in relief of migraine headaches. Although migraine is not currently an indication for PFO closure, the possible benefit of percutaneous PFO closure as a treatment for migraine headache will be revealed as results from further prospective randomized trials become available.

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Authors and Affiliations

  1. Department of Medicine, Montefiore Medical Center and Jacobi Medical Center, Albert Einstein College of Medicine, 1400 Pelham Parkway South, Building 1, Rm 3N1, Bronx, NY, USA

    M. Khalid Mojadidi MD

  2. Division of Cardiology, University of California, Los Angeles, Los Angeles, CA, USA

    M. Khalid Mojadidi MD, Nimit Dave & Rubine Gevorgyan MD

  3. Department of Medicine, Cardiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA

    Rubine Gevorgyan MD

  4. Interventional Cardiology, University of California, Los Angeles (UCLA), 10833 Le Conte Avenue, B976 Factor Building CHS, Los Angeles, CA, 90095, USA

    Jonathan M. Tobis MD, FACC

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  1. M. Khalid Mojadidi MD
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  2. Nimit Dave
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  3. Rubine Gevorgyan MD
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  4. Jonathan M. Tobis MD, FACC
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Corresponding author

Correspondence to Jonathan M. Tobis MD, FACC .

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Editors and Affiliations

  1. Children's Hospital of Georgia, Augusta, Georgia, USA

    Zahid Amin

  2. UCLA, Los Angeles, California, USA

    Jonathan M. Tobis

  3. CardioVascular Center, Frankfurt, Germany

    Horst Sievert

  4. University of Colorado Denver Anschutz Medical Campus, Aurora, Colorado, USA

    John D. Carroll

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Mojadidi, M.K., Dave, N., Gevorgyan, R., Tobis, J.M. (2015). The Association of Patent Foramen Ovale and Migraine Headache. In: Amin, Z., Tobis, J., Sievert, H., Carroll, J. (eds) Patent Foramen Ovale. Springer, London. https://doi.org/10.1007/978-1-4471-4987-3_10

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