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Updated: Jun 3, 2026
Closure of a Patent Foramen Ovale (PFO): An Intervention Sequence
Published on: December 23, 2022
Patent foramen ovale in children with migraine headaches
Rachel T McCandless1, Cammon B Arrington, Douglas C Nielsen
1Division of Cardiology, Department of Pediatrics, Primary Children's Medical Center and the University of Utah, Salt Lake City, UT, USA. rachel.mccandless@hsc.utah.edu
Insights
Children with migraine with aura have a higher prevalence of patent foramen ovale (PFO). This finding suggests PFO may play a role in migraine with aura development in pediatric patients.
Area of Science:
- Pediatric Neurology
- Cardiology
- Genetics
Background:
- Patent foramen ovale (PFO) is a common cardiac anomaly.
- The association between PFO and migraine, particularly in children, requires further investigation.
- Migraine with aura presents unique diagnostic and therapeutic challenges in pediatric populations.
Purpose of the Study:
- To investigate the prevalence of PFO in children diagnosed with migraine.
- To compare PFO prevalence in children with migraine with aura versus those without aura.
- To assess the potential link between PFO and the pathogenesis of pediatric migraine with aura.
Main Methods:
- A cohort of 109 children (aged 6-18) with migraine underwent evaluation for PFO and right-to-left shunting.
- Diagnostic tools included color-flow Doppler scanning, contrast transthoracic echocardiography, and contrast transcranial Doppler scanning.
- Participants were categorized into migraine with aura and migraine without aura groups.
Main Results:
- Overall PFO prevalence in children with migraine was 35%, similar to the general population.
- PFO prevalence was significantly higher in children with migraine with aura (50%) compared to those without aura (27%).
- No association was found between atrial shunt size and the presence or absence of aura.
Conclusions:
- Children experiencing migraine with aura exhibit a notably higher prevalence of PFO.
- These findings suggest that PFO may be a contributing factor in the development of migraine with aura in pediatric patients.
- The study highlights the importance of considering PFO in the clinical evaluation and management of children with migraine with aura.
Objective:
To determine the prevalence of patent foramen ovale (PFO) in children with migraine.
Study Design:
Children aged 6.0 to 18.0 years with migraine headache were evaluated for PFO and right-to-left shunting with color-flow Doppler scanning, saline solution contrast transthoracic echocardiography, and contrast transcranial Doppler scanning.
Results:
The population consisted of 109 children with migraine; 38 (35%) with aura and 71 (65%) without aura. The overall PFO prevalence was 35%, similar to the general population (35% vs 25%; P = .13). However, compared with the general population (25%), the PFO prevalence was significantly greater in subjects with aura (50%, P = .0004) but similar in those without aura (27%, P = .73). Atrial shunt size was not associated with the presence or absence of aura.
Conclusion:
Children with migraine with aura have a significantly higher prevalence of PFO compared with those without aura or the general population. These data suggest that PFO may contribute to the pathogenesis of migraine with aura in children and have implications for clinical decision making.
