Patent Foramen Ovale in Children with Migraine Headaches

• Published in: The Journal of pediatrics Vol. 159; no. 2; pp. 243 - 247.e1
• Main Authors: McCandless, Rachel T., MD, Arrington, Cammon B., MD, Nielsen, Douglas C, Bale, James F., MD, Minich, L. LuAnn, MD
• Format: Journal Article
• Language: English
• Published: Maryland Heights, MO Elsevier Inc 01-08-2011; Elsevier
• Subjects: Adolescent; Biological and medical sciences; Cardiology. Vascular system; Child; Congenital heart diseases. Malformations of the aorta, pulmonary vessels and vena cava; Echocardiography, Doppler, Color; Female; Follow-Up Studies; Foramen Ovale, Patent - complications; Foramen Ovale, Patent - diagnostic imaging; Foramen Ovale, Patent - epidemiology; General aspects; Heart; Humans; Male; Medical sciences; Migraine Disorders - complications; Migraine Disorders - diagnostic imaging; Migraine Disorders - epidemiology; Neurology; Pediatrics; Prevalence; Prognosis; Retrospective Studies; Risk Factors; Ultrasonography, Doppler, Transcranial; United States - epidemiology; Vascular diseases and vascular malformations of the nervous system; TCD; TTE; Transthoracic echocardiography; PFO; Patent foramen ovale; PedMIDAS; Pediatric Migraine Disability Assessment; Transcranial Doppler; Human; Headache; Pediatrics; Nervous system diseases; Respiratory disease; Persistent fetal circulation; Migraine; Cardiovascular disease; Congenital disease; Pulmonary hypertension; Cerebral disorder; Vascular disease; Newborn diseases; Pain; Respiratory failure; Heart disease; Central nervous system disease; Neurological disorder; Child; Ostium secundum; Cerebrovascular disease
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/j.jpeds.2011.01.062

Objective To determine the prevalence of patent foramen ovale (PFO) in children with migraine. Study design Children aged 6.0 to 18.0 years with migraine headache were evaluated for PFO and right-to-left shunting with color-flow Doppler scanning, saline solution contrast transthoracic echocardiography, and contrast transcranial Doppler scanning. Results The population consisted of 109 children with migraine; 38 (35%) with aura and 71 (65%) without aura. The overall PFO prevalence was 35%, similar to the general population (35% vs 25%; P = .13). However, compared with the general population (25%), the PFO prevalence was significantly greater in subjects with aura (50%, P = .0004) but similar in those without aura (27%, P = .73). Atrial shunt size was not associated with the presence or absence of aura. Conclusion Children with migraine with aura have a significantly higher prevalence of PFO compared with those without aura or the general population. These data suggest that PFO may contribute to the pathogenesis of migraine with aura in children and have implications for clinical decision making.