MIGRAINE AND PATENT FORAMEN OVALE - CASE REPORT
Keywords:
migraine, patent foramen ovaleAbstract
Migraine is a headache disorder, typically characterized by unilateral headache (with or without aura) of pulsating quality, which is associated with nausea, phonophobia and photophobia. The patent foramen ovale (PFO) is a remnant of the fetal circulation. Multiple studies suggest that migraine is more prevalent in subjects with PFO and vice versa, suggesting that PFO and migraine may be risk factors for each other.
Case report. We present a 33-year-old female patient with unilateral hemicranial headache, mostly on the right side, pain in the right eye, nausea, vomiting, photo and phonophobia, with previous visual difficulties with the ipsilateral eye. The complaints usually lasted 2-3 days and were associated mostly with the menstrual cycle. There were also occasional bouts of dizziness. Ophthalmological and otorhinolaryngological nature of these complaints was excluded with additional investigations. In addition, nuclear magnetic resonance (NMR) of the brain, color Doppler duplex sonography (CDDS) of carotid and vertebral arteries were performed, all with normal findings. On transcranial color Doppler sonography with Bubble test, a positive finding was obtained for a Grade 4 right-left shunt and the patient was referred for cardiology assessment and evaluation. The patient was diagnosed with migraine with aura (visual) and PFO.
Conclusion. Results from epidemiological studies examining the relationship between PFO and migraine are mixed at best. It is unclear if there is a causal relationship or simply a co-existence of these two conditions. More research of PFO in migraine is clearly needed before we can consider changing our views on the aforementioned conclusions.
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