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Contrast Echocardiography and Migraine in Divers with Patent Foramen Ovale

Published online by Cambridge University Press:  02 December 2014

Roberto Di Fabio ,
Elisabetta Giugni ,
Imerio Angeloni ,
Nicola Vanacore ,
Carlo Casali ,
Alberto Pierallini ,
Rita Vadalà  and
Francesco Pierelli
Roberto Di Fabio*
Affiliation:
Department of Neuromotor Rehabilitation, “Sapienza” University of Rome Polo Pontino - I.C.O.T., Latina
Elisabetta Giugni
Affiliation:
Department of Radiology, IRCSS-S Raffaele Pisana
Imerio Angeloni
Affiliation:
Cardiological Unit, National Health Institute, Rome
Nicola Vanacore
Affiliation:
Department of Epidemiology, National Health Institute, Rome
Carlo Casali
Affiliation:
Department of Neuromotor Rehabilitation, “Sapienza” University of Rome Polo Pontino - I.C.O.T., Latina
Alberto Pierallini
Affiliation:
Department of Radiology, IRCSS-S Raffaele Pisana
Rita Vadalà
Affiliation:
Department of Radiology, IRCSS-S Raffaele Pisana
Francesco Pierelli
Affiliation:
Department of Neuromotor Rehabilitation, “Sapienza” University of Rome Polo Pontino - I.C.O.T., Latina
*
Department of Neuromotor Rehabilitation, "Sapienza" University of Rome Polo Pontino ' I.C.O.T., via Francesco Faggiana 34, 004100, Latina, Italy. E-mail: rob.dif@tiscali.it
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Abstract

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Background:

It has been proposed that the patent foramen ovale (PFO) may be associated with migraine, in particular migraine with aura. However, it is not clear whether paradoxical embolism triggers crises of headache. Cerebral embolization is provoked in subjects with PFO through contrast echocardiography, a safe method to diagnose the presence of foramen ovale pervium.

Methods:

Twenty-four men practicing diving, an activity characterized by increased prevalence of PFO and migraine, underwent trans-thoracic echocardiography with contrast solution, composed of saline and air mixture and checked for the occurrence of migraine in the following 24 hours.

Results:

A PFO (five of minimal size, i.e. visible only during Valsalva, one of small and two of medium size) was detected in 8/24 divers (33%). No one reported headache over the 24 hours after the procedure.

Discussion:

Our preliminary data suggest that cerebral micro-embolism, provoked by contrast echocardiography, does not systematically trigger migraine crises when a minimal-to-medium sized patent foramen ovale is present.

Type
Other
Information
Canadian Journal of Neurological Sciences , Volume 36 , Issue 6 , November 2009 , pp. 740 - 744
Copyright
Copyright © The Canadian Journal of Neurological 2009

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