Children with migraine with aura and patent foramen ovale

As many as 80% of people have a hole in their hearts that closes up before they are even born. But among people who experience migraine with aura (visual or other sensory disturbances occurring before a migraine attack), the hole never closes in a larger than average percentage of people. Most studies on this issue have been done on adults, but researchers at the University of Utah recently studied this condition, known as patent foramen ovale, in a group of children.

Patent foramen ovale (PFO) is a condition in which there is a flap or opening between the two upper chambers of the heart. This opening allows blood to flow back and forth between the chambers, bypassing the lungs, which filter the blood to remove debris. If this debris is not filtered out it can travel to the brain, causing a stroke.

Researchers have observed that people living with migraine with aura are more likely to have PFO. In this study of children researchers found that 35% of the study participants who had migraine with aura had PFO, while only 25% of the non-migraine control group had PFO. Among study participants with migraine without aura the occurrence of PFO was similar to the non-migraine group.

It is unknown what the exact relationship between migraine with aura and PFO might be. Studies have been conducted to determine the effect of closing the PFO on migraine frequency, but the results have been largely inconclusive. While some doctors continue to suggest trying the procedure if all other prevention efforts have failed, others do not believe there is any causal relationship between PFO and migraine disease that warrants closing the pfo for migraine prevention alone. The most recent data seems to support the latter view that there is no value for migraine prevention in PFO closure.

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