Paradoxical Air Microembolism Induces Cerebral Bioelectrical Abnormalities and Occasionally Headache in Patent Foramen Ovale Patients With Migraine

نویسندگان

  • Eser Başak Sevgi
  • Sefik Evren Erdener
  • Mehmet Demirci
  • Mehmet Akif Topcuoglu
  • Turgay Dalkara
چکیده

BACKGROUND Although controversial, paradoxical embolism via patent foramen ovale (PFO) may account for some of the migraine attacks in a subset of migraine with aura (MA) patients. Induction of MA attacks with air bubble injection during transcranial Doppler ultrasound in MA patients with PFO supports this view. It is likely that cerebral embolism in patients with right-to-left shunt induces bioelectrical abnormalities to initiate MA under some conditions. METHODS AND RESULTS We investigated changes in cerebral bioelectrical activity after intravenous microbubble injection in 10 MA patients with large PFO and right-to-left cardiac shunt. Eight PFO patients without migraine but with large right-to-left shunt and 12 MA patients without PFO served as controls. Four MA patients with PFO were reexamined with sham injections of saline without microbubbles. Bioelectrical activity was evaluated using spectral electroencephalography and, passage of microbubbles through cerebral arteries was monitored with transcranial Doppler ultrasound. Microbubble embolism caused significant electroencephalographic power increase in MA+PFO patients but not in control groups including the sham-injected MA+PFO patients. Headache developed in 2 MA with PFO patients after microbubble injection. CONCLUSIONS These findings demonstrate that air microembolism through large PFOs may cause cerebral bioelectrical disturbances and, occasionally, headache in MA patients, which may reflect an increased reactivity of their brain to transient subclinical hypoxia-ischemia, and suggest that paradoxical embolism is not a common cause of migraine but may induce headache in the presence of a large PFO and facilitating conditions.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Migraine headache relief after transcatheter closure of patent foramen ovale.

OBJECTIVES The purpose of this study was to determine the effects of transcatheter patent foramen ovale (PFO) closure on migraine frequency in patients with paradoxical cerebral embolism. BACKGROUND The prevalence of migraine headache is higher in cryptogenic stroke patients with PFO than in the general population. Previous studies have suggested that closure of the PFO may reduce migrainous ...

متن کامل

Impact of percutaneous patent foramen ovale closure on migraine course

Migraine is a neurological disorder characterized by an increased individual susceptibility to respond to certain triggers by a propagating wave of neuronal depolarization that culminates in typical migraine headaches. Patients with a patent foramen ovale or any kind of right-to-left shunt are more likely to have migraine; and patients with migraine with aura are more likely to have a patent fo...

متن کامل

A patient with pulmonary arteriovenous fistulas (P-AVFs) in whom migraine disappeared after transcatheter coil embolization for the secondary prevention of paradoxical infarction. A case report.

Dear Editor, We experienced a patient, a 40-year-old woman, with left visual field disturbance immediately following a migraine attack. She had a history of migraine with aura (scintillating scotoma) since 10 years of age, and of hereditary hemorrhagic telangiectasia (HHT). Right occipital infarction and right posterior cerebral artery stenosis were confirmed on magnetic resonance imaging and a...

متن کامل

Patent Foramen Ovale

Patent foramen ovale (PFO) is not uncommondit appears in perhaps 10% to 25% of the populationdbut only a small percent of cases will produce any clinical sequelae, such as refractory hypoxia, orthodeoxia-platypnea syndrome, or migraine headaches. PFO is most notorious, however, for its association with paradoxical embolus and cryptogenic stroke (1). Conclusive proof of a causal relationship bet...

متن کامل

Microembolism during foam sclerotherapy of varicose veins.

To the Editor: Chronic venous insufficiency is a common disease in adulthood. One recently developed therapy for varicose veins is foam sclerotherapy.1 We used foam sclerotherapy in a 51-year-old man and a 33-year-old woman who had symptomatic varicose great saphenous veins and were otherwise healthy. Immediately after the initiation of treatment, transient scotomas developed in the man, and a ...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:

دوره 1  شماره 

صفحات  -

تاریخ انتشار 2012