Ahmed H Shafeeq, Pulkurthi Sneha Reddy, Dias Akhil Fravis, Zahid Maryam, Vishwanatham Varshini
Bangalore Medical College and Research Institute, K.R Road, Bangalore, 560002 Karnataka India.
M S Ramaiah Medical College, M S Ramaiah Nagar, Bangalore, 560054 Karnataka India.
Indian J Thorac Cardiovasc Surg. 2025 Apr;41(4):426-440. doi: 10.1007/s12055-025-01906-x. Epub 2025 Feb 18.
Migraine is a complex neurological disorder marked by severe headache and associated with various systemic symptoms. Atrial septal defect (ASD) closure, a common cardiac procedure, has been linked to the onset of new migraine episodes. This systematic review explores the incidence and management of migraine following transcatheter ASD closure.
A comprehensive literature search was conducted in PubMed, Scopus, and CINAHL Ultimate, covering studies from inception to August 2024. The review followed PRISMA guidelines and was registered on PROSPERO (CRD42024578609). Data extraction and risk of bias assessment were systematically performed by independent reviewers.
A total of 831 studies were identified out of which 13 were included for the final analysis. The studies encompassed diverse populations globally, revealing varying onset times for migraine post-ASD closure, ranging from as early as 1 day to up to a year. Migraine incidence varied significantly, with several studies noting a higher prevalence in females and some cases showing a familial predisposition typically in the maternal side. The typical methods for ASD closure involved transcatheter approaches. Treatment modalities included non-steroidal anti-inflammatory drugs, calcium channel blockers, and anticoagulants, with some cases experiencing spontaneous resolution of symptoms. Modifications to anti-platelet therapy post-procedure, such as the introduction of clopidogrel along with aspirin, showed significant efficacy in treating and preventing migraine.
This review highlights a significant correlation between ASD closure and the onset of migraine, underlining the need for further investigation into preventive strategies and management. These findings suggest a complex interaction between structural heart alterations and migraine pathophysiology.
The online version contains supplementary material available at 10.1007/s12055-025-01906-x.
偏头痛是一种复杂的神经系统疾病，其特征为严重头痛，并伴有各种全身症状。房间隔缺损（ASD）封堵术是一种常见的心脏手术，已被证实与新的偏头痛发作有关。本系统评价旨在探讨经导管ASD封堵术后偏头痛的发生率及治疗方法。
在PubMed、Scopus和CINAHL Ultimate数据库中进行了全面的文献检索，涵盖从数据库建立至2024年8月的研究。本评价遵循PRISMA指南，并在PROSPERO（CRD42024578609）上进行了注册。由独立的评审人员系统地进行数据提取和偏倚风险评估。
共检索到831项研究，其中13项纳入最终分析。这些研究涵盖了全球不同人群，显示ASD封堵术后偏头痛的发作时间各不相同，最早可在术后1天出现，最长可达1年。偏头痛的发生率差异显著，多项研究指出女性患病率较高，部分病例显示出家族易感性，通常为母系遗传。ASD封堵的典型方法为经导管途径。治疗方式包括非甾体类抗炎药、钙通道阻滞剂和抗凝剂，部分病例症状可自行缓解。术后调整抗血小板治疗，如联合使用氯吡格雷和阿司匹林，在治疗和预防偏头痛方面显示出显著疗效。
本评价强调了ASD封堵与偏头痛发作之间存在显著相关性，凸显了进一步研究预防策略和治疗方法的必要性。这些发现提示了结构性心脏改变与偏头痛病理生理学之间存在复杂的相互作用。
在线版本包含可在10.1007/s12055-025-01906-x获取的补充材料。
