What is the link between Migraine and PFO ?
A.Strong and evidence based
B.Weakly linked
C.May be , an Important link . (Will wait for evidence)
D.No link at all.
Answer:
There has been many postulations linking the two. 1.Cross over of vasoactive substances like serotonin . 2.Paradoxical microemboli that trigger a cortical migraine like aura .3.Transient hypoxemia due to right to left shunt during valsalva strain.
However ,the truth appears to be, it is more of an association , since both entities are very common in the general population.(Up to 20%) .If you ask for a pragmatic answer, it will be determined by the tempting desire to close an innocuous hole in the heart.
Postamble
While, the connection between migraine and PFO is speculative , but its link to cryptogenic stroke may be little more firm, although fear mongering is not warranted . (RoPE criteria: Risk of Paradoxical Embolism)
Reference
Dr.S.Venkatesan MD 