Document Detail

Patent Foramen Ovale and Migraine Attacks: A Systematic Review.
MedLine Citation:
PMID:  24355354     Owner:  NLM     Status:  Publisher    
BACKGROUND: Migraine headache and the presence of a patent foramen ovale have been associated with each other, although the precise pathophysiological mechanism(s) are uncertain. The purpose of this systematic review was to identify the extent of patent foramen ovale prevalence in migraineurs and to determine whether closure of a PFO would improve MH.
METHODS: An electronic literature search was performed to select studies between January 1980 and February 2013 that were relevant to the prevalence of patent foramen ovale and migraine, and the effects of intervention(s) on migraine attacks. Of the initial 368 articles presented by the initial search, 20 satisfied the inclusion criteria assessing patent foramen ovale prevalence in migraineurs and 21 presented data on patent foramen ovale closure.
RESULTS: In case series and cohort studies, patent foramen ovale prevalence in migraineurs ranged from 14.6% to 66.5%. Case control studies reported a prevalence ranging from 16.0% to 25.7% in controls, compared to 26.8% to 96.0% for migraine with aura. The extent of improvement or resolution of migraine headache attack symptoms was variable. In case series, intervention ameliorated migraine headache attack in 13.6% to 92.3% of cases. One single randomised trial did not show any benefit from patent foramen ovale closure. The data overall do not exclude the possibility of a placebo effect for resolving migraine following patent foramen ovale closure.
CONCLUSION: This systematic review demonstrates firstly that migraine headache attack is associated with a higher prevalence of patent foramen ovale than amongst the general population. Observational data suggest some improvement of migraine would be observed if the patent foramen ovale were to be closed. A proper assessment of any interventions for patent foramen ovale closure would require further large randomised trials to be conducted given uncertainties from existing trial data.
Philomena Z Y Lip; Gregory Y H Lip
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-12-16
Journal Detail:
Title:  The American journal of medicine     Volume:  -     ISSN:  1555-7162     ISO Abbreviation:  Am. J. Med.     Publication Date:  2013 Dec 
Date Detail:
Created Date:  2013-12-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0267200     Medline TA:  Am J Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013 Elsevier Inc. All rights reserved.
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