Closure of a Patent Foramen Ovale: Effective Therapy of Migraine and Occipital Stroke

Whether stroke in a patient with migraine and patent foramen ovale (PFO) is due to PFO or migraine is difficult to decide. In a 33-year-old woman with migraine with aura, a visual field defect developed acutely. Neurological investigation revealed double vision when looking to the left and exaggerat...

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Bibliographic Details
Published in:International journal of neuroscience 2005-01, Vol.115 (1), p.119-127
Main Authors: FINSTERER, JOSEF, SOMMER, OLIVER, STISKAL, MICHAEL, STÖLLBERGER, CLAUDIA, BAUMGARTNER, HELMUT
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
Cardiac Catheterization
cerebrovascular ischemia
echocardiography
Female
Heart Septal Defects, Atrial - complications
Heart Septal Defects, Atrial - pathology
Heart Septal Defects, Atrial - surgery
Humans
Medical sciences
Migraine Disorders - etiology
Migraine Disorders - pathology
Migraine Disorders - surgery
Neurology
Occipital Lobe - pathology
ophthalmologic impairment
Stroke - etiology
Stroke - pathology
Stroke - surgery
stroke-prevention
therapy, vision
Vascular diseases and vascular malformations of the nervous system
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Summary:Whether stroke in a patient with migraine and patent foramen ovale (PFO) is due to PFO or migraine is difficult to decide. In a 33-year-old woman with migraine with aura, a visual field defect developed acutely. Neurological investigation revealed double vision when looking to the left and exaggerated patella tendon reflexes. Since then the patient complained about permanent visual impairment. CT- and MRI-scans of the brain showed a right occipital ischemic stroke. Intensive search for risk factors revealed cigarette smoking and chronic hypovolemia. On transesophageal echocardiography an inter-atrial hypermobile septum and a PFO were detected. The patient underwent closure of the PFO by means of an Amplatzer PFO occluder nine weeks after the stroke. Since then she did not experience a further cerebrovascular event or migraine attack. This case shows that in a patient with PFO and migraine with aura, stroke may be attributable to migraine rather than to PFO. Occlusion of the PFO may reduce the frequency and intensity of migraine attacks.
ISSN:0020-7454
1563-5279
1543-5245
DOI:10.1080/00207450490512687