Migraine and patent foramen ovale

Abstract

A 50-year-old shop assistant was admitted to my clinic from the cardiologist for neurological examination before planned patent foramen ovale (PFO) closure. The woman reported that she suffers from an episodic migraine since her 20s. Approximately four times a month, she has severe pulsating headache attacks accompanied by nausea, phono-, and photophobia. Pain is aggravated by routine physical activity and she prefers to lie down and sleep. Sometimes she sees flickering lights for approximately 15 min in terms of a visual aura before headache starts. When pain gets worse she takes ibuprofen which shows some beneficial effect. A prophylactic medication has never been tried.