[Migraine and patent foramen ovale]

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Updated: May 12, 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

C Lucas1

  • 1Service de neurologie et pathologie neurovasculaire, hôpital Salengro, CHRU de Lille, rue Émile-Laine, 59037 Lille cedex, France. christian.lucas@chru-lille.fr

Revue Neurologique
|April 23, 2013
PubMed

Insights

Patent foramen ovale (PFO) is linked to migraine with aura, but evidence for a causal link is weak. PFO closure is not currently recommended for migraine treatment due to conflicting data and risks.

Area of Science:

  • Cardiology
  • Neurology
  • Medical Research

Context:

  • Observational studies suggest a higher prevalence of patent foramen ovale (PFO) in migraineurs with aura.
  • Conversely, patients with PFO show an increased prevalence of migraine and migraine with aura.
  • Conflicting data exist regarding the causal relationship between PFO and migraine.

Purpose:

  • To evaluate the association between patent foramen ovale (PFO) and migraine with aura.
  • To review pathophysiological mechanisms linking PFO and migraine.
  • To assess the efficacy and safety of PFO closure for migraine treatment.

Summary:

  • Recent meta-analyses do not support a direct association between PFO and migraine.
  • Potential mechanisms include microembolization affecting cerebral oxygen saturation and release of vasoactive substances.
  • The MIST study, a prospective trial, reported negative results for migraine with aura cure and highlighted significant morbidity associated with PFO closure.

Impact:

  • Despite some retrospective analyses suggesting improvement after PFO closure, the evidence grade is very low.
  • The current evidence precludes definitive conclusions on the benefits of PFO closure for migraine with aura.
  • PFO closure is not recommended in clinical practice for patients with migraine with aura.

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