Patent foramen ovale in trigeminal autonomic cephalalgias and hemicrania continua: a non-specific pathophysiological occurrence?

Abstract

Patent foramen ovale (PFO), a relatively common abnormality in adults, has been associated with migraine. Few studies also linked PFO with cluster headache (CH). To verify whether right-to-left shunt (RLS) is related to headaches other than migraine and CH, we used transcranial Doppler following microbubbles injection to detect shunts in 24 CH, 7 paroxysmal hemicrania (PH), one SUNCT, two hemicrania continua (HC) patients; and 34 matched controls. RLS was significantly more frequent in CH than in controls (54% vs. 25%, p=0.03), particularly above the age of 50. In the HC+PH+SUNCT group, RLS was found in 6 patients and in 2 controls (p=0.08). Smoking as well as the Epworth Sleepiness Scale correlated significantly with CH, smoking being more frequent in patients with RLS. PFO may be non-specifically related to trigeminal autonomic cephalalgias and HC. The headache phenotype in PFO patients probably depends on individual susceptibility to circulating trigger factors.

• Authors: Vanise Amaral, Gabriel R de Freitas, Bruno C B Rodrigues, Daniel de H Christoph, Carlos A de Pinho, Cristiana de Faria P Góes, Maurice B Vincent
• Journal: Arquivos de neuro-psiquiatria (Arq Neuropsiquiatr) Vol. 68 Issue 4 Pg. 627-31 (Aug 2010) ISSN: 1678-4227 [Electronic] Germany
• PMID: 20730322 (Publication Type: Journal Article)

Topics

• Adult
• Case-Control Studies
• Female
• Foramen Ovale, Patent (complications, diagnostic imaging, physiopathology)
• Headache (diagnostic imaging, etiology, physiopathology)
• Humans
• Male
• Middle Aged
• Trigeminal Autonomic Cephalalgias (diagnostic imaging, etiology, physiopathology)
• Ultrasonography, Doppler, Transcranial