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Updated: Aug 6, 2026

Closure of a Patent Foramen Ovale (PFO): An Intervention Sequence
10:52

Closure of a Patent Foramen Ovale (PFO): An Intervention Sequence

Published on: December 23, 2022

[Patent foramen ovale and migraine, a fortuitus association or a causal relationship?]

J Schoenen1, Ph Burette, P Materne

  • 1Unité de Recherches sur les Céphalées, Service de Neurologie, CHR Citadelle, Liège, Belgique. jschoenen@ulg.ac.be

Revue Medicale De Liege
|August 17, 2006
PubMed

Insights

Migraine with aura is linked to patent foramen ovale (PFO). While PFO closure may reduce migraine frequency, definitive evidence from controlled trials is pending, so it is not currently recommended for migraine treatment.

Area of Science:

  • Neurology
  • Cardiology
  • Genetics

Background:

  • Migraine with aura (MWA) frequently co-occurs with patent foramen ovale (PFO).
  • MWA is a risk factor for ischemic stroke in individuals under 55, with PFO implicated in some cases.
  • The etiological relationship between PFO and MWA remains unclear, with possibilities including causal links or shared genetic factors.

Observation:

  • Cortical spreading depression, the mechanism behind migrainous aura, might be facilitated by a PFO.
  • Retrospective, uncontrolled studies indicate that percutaneous PFO closure, performed for stroke or decompression illness, may decrease migraine attack frequency.
  • These observed benefits include reductions in migraines with and without aura.

Findings:

  • Evidence suggests a potential link between PFO and migraine, with some studies showing reduced migraine frequency after PFO closure.
  • The precise role of PFO in migraine pathophysiology requires further investigation.
  • Current data is largely from uncontrolled studies, necessitating more rigorous research.

Implications:

  • Prospective, controlled trials are underway to definitively assess the efficacy of PFO closure for migraine management.
  • Until trial results are available, there is no established rationale for recommending PFO closure specifically for treating migraine.
  • Further research will clarify the therapeutic potential of PFO intervention in patients with migraine and PFO.

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