Skip to main content

Advertisement

SpringerLink
Log in

Influence of transcatheter closure of atrial communication on migraine headache in patients with ischemic stroke

  • Original Article
  • Published:
Cardiovascular Intervention and Therapeutics Aims and scope Submit manuscript

Abstract

Some types of migraine are associated with ischemic stroke. Although a right-to-left communication is linked with ischemic stroke, a causal relationship between migraine and right-to-left communication remains unclear. Furthermore, the efficacy of transcatheter closure of atrial communication on migraine is controversial. We aimed to evaluate the influence of transcatheter closure of atrial communication on migraine in patients with ischemic stroke. Thirty-eight consecutive patients with ischemic stroke who underwent transcatheter closure of atrial communication were enrolled. The prevalence, frequency, and severity of migraine were prospectively evaluated at baseline, 3 months, and >6 months after the procedure. Changes in migraine after the procedure were classified according to the frequency and severity of migraine: disappeared, improved, no-change, and worsening. Nineteen (50 %) of 38 patients suffered from migraine at baseline. No significant differences were observed in age, comorbidities, defect diameter, and atrial septal aneurysm between patients with migraine and patients without migraine. Among the 19 patients with migraine, migraine disappeared in 10 (53 %) patients and improved in 8 (42 %) patients at 3 months after transcatheter closure of atrial communication. At mean follow-up of 38 ± 28 months after the procedure, migraine disappeared in 12 (63 %) patients and improved in five (26 %) patients. No patients experienced worsening of migraine during the follow-up period. New-onset migraine was not observed in patients without migraine. Migraine is complicated in a half of patients with ischemic stroke related to atrial communication. Such migraine may disappear or improve after transcatheter closure of atrial communication.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Stewart WF, Shechter A, Rasmussen BK. Migraine prevalence. A review of population-based studies. Neurology. 1994;44:S17–23.

    CAS  PubMed  Google Scholar 

  2. Spector JT, Kahn SR, Jones MR, Jayakumar M, Dalal D, Nazarian S. Migraine headache and ischemic stroke risk: an updated meta-analysis. Am J Med. 2010;123:612–24.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Elliott D. Migraine and stroke: current perspectives. Neurol Res. 2008;30:801–12.

    Article  PubMed  Google Scholar 

  4. D’Andrea G, Hasselmark L, Alecci M, Cananzi A, Perini F, Welch KM. Platelet secretion from dense and alpha-granules in vitro in migraine with or without aura. J Neurol Neurosurg Psychiatry. 1994;57:557–61.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Lechat P, Mas JL, Lascault G, Loron P, Theard M, Klimczac M, et al. Prevalence of patent foramen ovale in patients with stroke. N Engl J Med. 1988;318:1148–52.

    Article  CAS  PubMed  Google Scholar 

  6. Post MC, Thijs V, Herroelen L, Budts WI. Closure of a patent foramen ovale is associated with a decrease in prevalence of migraine. Neurology. 2004;62:1439–40.

    Article  PubMed  Google Scholar 

  7. Reisman M, Christofferson RD, Jesurum J, Olsen JV, Spencer MP, Krabill KA, et al. Migraine headache relief after transcatheter closure of patent foramen ovale. J Am Coll Cardiol. 2005;45:493–5.

    Article  PubMed  Google Scholar 

  8. Schwedt TJ, Demaerschalk BM, Dodick DW. Patent foramen ovale and migraine: a quantitative systematic review. Cephalalgia. 2008;28:531–40.

    Article  CAS  PubMed  Google Scholar 

  9. Mortelmans K, Post M, Thijs V, Herroelen L, Budts W. The influence of percutaneous atrial septal defect closure on the occurrence of migraine. Eur Heart J. 2005;26:1533–7.

    Article  PubMed  Google Scholar 

  10. Garg P, Servoss SJ, Wu JC, Bajwa ZH, Selim MH, Dineen A, et al. Lack of association between migraine headache and patent foramen ovale: results of a case-control study. Circulation. 2010;121:1406–12.

    Article  PubMed  Google Scholar 

  11. Rundek T, Elkind M, Tullio M, Carrera E, Jin Z, Sacco RL, et al. Patent foramen ovale and migraine. Circulation. 2008;118:1419–24.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Chambers J, Seed PT, Ridsdale L. Association of migraine aura with patent foramen ovale and atrial septal aneurysms. Int J Cardiol. 2013;168:3949–53.

    Article  PubMed  Google Scholar 

  13. Wilmshurst PT, Nightingale S, Walsh KP, Morrison WL. Effect on migraine of closure of cardiac right-to-left shunts to prevent recurrence of decompression illness or stroke or for haemodynamic reasons. Lancet. 2000;356:1648–51.

    Article  CAS  PubMed  Google Scholar 

  14. Trabattoni D, Fabbiocchi F, Montorsi P, Galli S, Teruzzi G, Grancini L, et al. Sustained long-term benefit of patent foramen ovale closure on migraine. Catheter Cardiovasc Interv. 2011;77:570–4.

    Article  PubMed  Google Scholar 

  15. Rigatelli G, Dell’Avvocata F, Ronco F, Cardaioli P, Giordan M, Braggion G, et al. Primary transcatheter patent foramen ovale closure is effective in improving migraine in patients with high-risk anatomic and functional characteristics for paradoxical embolism. JACC Cardiovasc Interv. 2010;3:282–7.

    Article  PubMed  Google Scholar 

  16. Azarbal B, Tobis J, Suh W, Chan V, Dao C, Gaster R. Association of interatrial shunts and migraine headaches: impact of transcatheter closure. J Am Coll Cardiol. 2005;45:489–92.

    Article  PubMed  Google Scholar 

  17. Dowson A, Mullen MJ, Peatfield R, Muir K, Khan AA, Wells C, et al. Migraine intervention with STARFlex technology (MIST) trial: a prospective, multicenter, double-blind, sham-controlled trial to evaluate the effectiveness of patent foramen ovale closure with STARFlex septal repair implant to resolve refractory migraine headache. Circulation. 2008;117:1397–404.

    Article  PubMed  Google Scholar 

  18. Mugge A, Daniel WG, Angermann C, Spes C, Khandheria BK, Kronzon I, et al. Atrial septal aneurysm in adult patients. A multicenter study using transthoracic and transesophageal echocardiography. Circulation. 1995;91:2785–92.

    Article  CAS  PubMed  Google Scholar 

  19. Thanopoulos BD, Laskari CV, Tsaousis GS, Zarayelyan A, Vekiou A, Papadopoulos GS. Closure of atrial septal defects with the Amplatzer occlusion device: preliminary results. J Am Coll Cardiol. 1998;31:1110–6.

    Article  CAS  PubMed  Google Scholar 

  20. Kijima Y, Akagi T, Nakagawa K, Taniguchi M, Ueoka A, Deguchi K, et al. Catheter closure of patent foramen ovale in patients with cryptogenic cerebrovascular accidents: initial experiences in Japan. Cardiovasc Interv Ther. 2014;29:11–7.

    Article  PubMed  Google Scholar 

  21. Headache Classification Subcommittee of the International Headache Society. The International Classification of Headache Disorders: 2nd edition. Cephalalgia. 2004;24:9–160.

    Article  Google Scholar 

  22. Wilmshurst P, Nightingale S. Relationship between migraine and cardiac and pulmonary right-to-left shunts. Clin Sci. 2001;100:215–20.

    Article  CAS  PubMed  Google Scholar 

  23. Kurth T, Tzourio C, Bousser MG. Migraine: a matter of the heart? Circulation. 2008;118:1405–7.

    Article  PubMed  Google Scholar 

  24. Kai H, Koyanagi S, Hirooka Y, Sugimachi M, Sadoshima J, Suzuki S, et al. Right-to-left shunt across atrial septal defect related to tricuspid regurgitation: assessment by transesophageal Doppler echocardiography. Am Heart J. 1994;127:578–84.

    Article  CAS  PubMed  Google Scholar 

  25. Luermans JG, Post MC, Temmerman F, Thijs V, Schonewille WJ, Plokker HW, et al. Is a predominant left-to-right shunt associated with migraine?: a prospective atrial septal defect closure study. Catheter Cardiovasc Interv. 2009;74:1078–84.

    Article  PubMed  Google Scholar 

  26. Truong T, Slavin L, Kashani R, Higgins J, Puri A, Chowdhry M, et al. Prevalence of migraine headaches in patients with congenital heart disease. Am J Cardiol. 2008;101:396–400.

    Article  PubMed  Google Scholar 

  27. van der Kuy PH, Lohman JJ. A quantification of the placebo response in migraine prophylaxis. Cephalalgia. 2002;22:265–70.

    Article  PubMed  Google Scholar 

  28. Wilmshurst PT, Nightingale S, Walsh KP, Morrison WL. Clopidogrel reduces migraine with aura after transcatheter closure of persistent foramen ovale and atrial septal defects. Heart. 2005;91:1173–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Hornung M, Bertog SC, Franke J, Id D, Taaffe M, Wunderlich N, et al. Long-term results of a randomized trial comparing three different devices for percutaneous closure of a patent foramen ovale. Eur Heart J. 2013;34:3362–9.

    Article  PubMed  Google Scholar 

  30. Mortelmans K, Post M, Thijs V, Herroelen L, Budts W. The influence of percutaneous atrial septal defect closure on the occurrence of migraine. Eur Heart J. 2005;26:1533–7.

    Article  PubMed  Google Scholar 

  31. Sharifi M, Dehghani M, Mehdipour M, Al-Bustami O, Emrani F, Burks J. Intense migraines secondary to percutaneous closure of atrial septal defects. J Interv Cardiol. 2005;18:181–3.

    Article  PubMed  Google Scholar 

  32. Rodes-Cabau J, Horlick E, Ibrahim R, Cheema AN, Labinaz M, Nadeem N, et al. Effect of clopidogrel and aspirin vs aspirin alone on migraine headaches after transcatheter atrial septal defect closure: the CANOA randomized clinical trial. JAMA. 2015;9:1–8.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama, Japan

    Yoichi Takaya, Yasufumi Kijima, Koji Nakagawa & Hiroshi Ito

  2. Cardiac Intensive Care Unit, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, 2-5-1 Shikata-cho, Kita-Ku, Okayama, 700-8558, Japan

    Teiji Akagi

  3. Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama, Japan

    Syoichiro Kono & Kentaro Deguchi

  4. Department of Cardiovascular Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama, Japan

    Shunji Sano

Authors
  1. Yoichi Takaya
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Teiji Akagi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yasufumi Kijima
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Koji Nakagawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Syoichiro Kono
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Kentaro Deguchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Shunji Sano
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Hiroshi Ito
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Teiji Akagi.

Ethics declarations

Conflicts of interest

Dr. Akagi is a consultant for St. Jude Medical, Inc. The other authors have no relationships relevant to the contents of this paper to disclose.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Takaya, Y., Akagi, T., Kijima, Y. et al. Influence of transcatheter closure of atrial communication on migraine headache in patients with ischemic stroke. Cardiovasc Interv and Ther 31, 263–268 (2016). https://doi.org/10.1007/s12928-015-0375-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12928-015-0375-8

Keywords

Search

Navigation