Schoenen J, Burette Ph, Materne P
Unité de Recherches sur les Céphalées, Service de Neurologie, CHR Citadelle, Liège, Belgique.
Rev Med Liege. 2006 May-Jun;61(5-6):362-8.
Epidemiologic studies have shown a clear comorbidity between migraine with aura and a patent foramen ovale (PFO). Under the age of 55, migraine with aura is a risk factor for ischemic stroke and a proportion of the latter is due to a PFO. It remains to be determined whether PFO is causally related to migraine attacks, or is a fortuitous association due to common genetic factors. Cortical spreading depression which is the underlying mechanism of the migrainous aura, could be favoured by a PFO. Several retrospective and uncontrolled studies suggest that percutaneous closure of a PFO for stroke or decompression illness in divers reduces frequency of migraine attacks with, but also without aura. Multicentric, prospective and controlled trials of this intervention in migraineurs are underway or in preparation. As long as their results are not known, there is no rationale for proposing PFO closure for migraine.
流行病学研究表明，伴有先兆的偏头痛与卵圆孔未闭（PFO）之间存在明显的共病关系。在55岁以下，伴有先兆的偏头痛是缺血性中风的一个危险因素，且后者有一部分归因于PFO。PFO与偏头痛发作是否存在因果关系，或者只是由于共同的遗传因素而偶然关联，仍有待确定。作为偏头痛先兆潜在机制的皮层扩散性抑制，可能因PFO而加重。多项回顾性和非对照研究表明，经皮封堵PFO用于治疗潜水员的中风或减压病，可降低有先兆及无先兆偏头痛发作的频率。针对偏头痛患者进行这种干预的多中心、前瞻性和对照试验正在进行或筹备中。在其结果未知之前，没有理由建议为偏头痛患者封堵PFO。
