Children with Migraine and PFO

by Teri Robert, Lead Expert

A recent study looked at children with Migraine to determine the prevalence of patent foramen ovale (PFO) in children with Migraine.

What Is PFO
PFO stands for patent foramen ovale. A PFO is a hole in the wall (septum) that divides the right and left atrium (chambers) of the heart. We all have a PFO during fetal development, but it usually closes before birth. The right side of the heart receives blood and pumps it to the lungs for oxygenation. The blood then goes through the left side of the heart to be pumped to the brain and other organs. A PFO can allow blood that hasn't been oxygenated by the lungs to get into the left side of the heart, thus being pumped to the brain and other organs. If this happens, the body doesn't get enough oxygen. It's also possible that blood clots can pass through the PFO and cause a stroke.

Study methods:

  • Study participants were between the ages of six and 18.
  • There were 109 participants - 38 with aura (35%) and 71 without (65%).
  • Participants were diagnosed with Migraine with aura or Migraine without aura following International Headache Society criteria.
  • Participants were evaluated for PFO and right-to-left shunting with color-flow Doppler scanning, saline solution contrast transthoracic echocardiography, and contrast transcranial Doppler scanning.
  • Participants completed the pediatric MIDAS (Migraine Disability Assessment) to determine the frequency of their Migraines and resulting disability.
  • PFO prevalence was compared between:
    • all study Migraine participants versus the general population,
    • study participants with Migraine with aura versus the general population,
    • participants with Migraine without aura versus the general population, and
    • participants with Migraine with aura versus participants with Migraine without aura.

Study results:

  • Of all of the study participants, 50% were found to have PFO, compared to 25% in the general population.
  • In the group with Migraine with aura, the prevalence was significantly higher at 50%.
  • In the group with Migraine without aura, the prevalence was very close to that of the general population at 27%.
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