Interatrial shunt-associated migraine: serendipity, empiricism, hope, or hype?

摘要

Anzola et al found a dramatic reduction in incidence of migraine with aura after closure of patent foramen ovale (PFO) as well as overall improvement in migraine in a case-control study. For a disease that runs its course over several decades, a 12-month period of observation after PFO-closure is rather short. The suggestion that migraine may be causally linked to an unpredictable or intermittent right-to-left shunt (RLS) of PFO is seriously challenged by almost immediate aggravation or de novo appearance of migraine with aura after closure of atrial septal defect (ASD) that is, in turn, always associated with a left-to-right shunt.