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Updated: Jul 16, 2026

3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache
10:39

3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache

Published on: June 2, 2014

Migraine, patent foramen ovale and migraine triggers

Jose Tembl1, Aida Lago, Teresa Sevilla

  • 1Neurology Service, Universitary Hospital, La Fe, Avda Campanar 21, E-46009, Valencia, Spain. tembl-jos@gva.es

The Journal of Headache and Pain
|March 16, 2007
PubMed

Insights

Patients with migraine with aura may have a higher prevalence of right-to-left shunt (RLS). Activities that provoke Valsalva (VPA) were linked to increased RLS, suggesting a potential connection in migraine triggers.

Area of Science:

  • Neurology
  • Cardiology
  • Vascular Medicine

Background:

  • Limited understanding of the link between patent foramen ovale (PFO) and migraine.
  • Some migraine patients report Valsalva-provoking activities (VPA) as triggers.
  • Speculation of a pathogenic connection between VPA and migraine.

Purpose of the Study:

  • Investigate the prevalence of right-to-left shunt (RLS) in migraine with aura (MA) patients.
  • Examine the association between RLS and VPA-triggered migraine attacks.
  • Compare RLS prevalence in MA versus migraine without aura (MOA).

Main Methods:

  • Consecutive series of 72 MA patients and age/gender-matched MOA patients.
  • Assessment of RLS presence and extent using transcranial Doppler.
  • Inquiry into circumstances triggering migraine attacks, including VPA.

Main Results:

  • Massive RLS found in 38.9% of MA patients vs. 6.5% of MOA patients (p<0.001).
  • 45.8% of MA patients identified VPA as a headache trigger.
  • Trend observed between VPA and massive RLS (OR 2.7 in MA, OR 2.5 in all migraine patients).

Conclusions:

  • MA patients exhibit a significantly higher prevalence of massive RLS.
  • A potential association exists between larger RLS and VPA-triggered migraine attacks.
  • Activities increasing shunt extent may trigger migraine in patients with RLS.

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