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Updated: May 23, 2026
10:39
3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache
Published on: June 2, 2014
Right-to-left shunts and micro-embolization in migraine
Hille Koppen1, Inge H Palm-Meinders, Michel D Ferrari
1Department of Neurology, Haga Hospital, The Hague, The Netherlands. h.koppen@hagaziekenhuis.nl
Current Opinion in Neurology
|March 28, 2012
Summary
Right-to-left shunts (RLSs) are linked to migraine with aura, though the exact mechanism is unclear. While emboli may trigger attacks, closing RLSs is not recommended for migraine treatment in clinical practice.
Area of Science:
- Neurology
- Cardiology
Background:
- Migraine with aura is a complex neurological condition.
- Right-to-left shunts (RLSs) are increasingly studied for their potential role in migraine pathophysiology.
Purpose of the Study:
- To review recent studies on the association between RLSs and migraine.
- To explore the role of various emboli in triggering migraine attacks.
Main Methods:
- Literature review of recent studies on RLS prevalence in migraine patients.
- Analysis of evidence regarding emboli-induced cortical spreading depression and migraine.
Main Results:
- Conflicting evidence exists on RLS prevalence in migraine with aura; some studies show no increase, while others indicate a higher prevalence.
- Emboli introduced into the carotid artery in mice can induce cortical spreading depression, a mechanism implicated in migraine aura.
- Limited human data suggests iatrogenic emboli can provoke migraine attacks.
Conclusions:
- RLS and migraine with aura are considered comorbid, but the underlying biological mechanism requires further investigation.
- Specific types of emboli may infrequently induce migraine symptoms.
- Current evidence does not support the routine diagnosis or treatment of RLS in migraine patients outside of controlled studies.
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