Cryptogenic stroke - patent foramen ovale - migraine with aura: incidental triad or significant relationship? Part I

In the first part of the paper we discuss the association between patent foramen ovale (PFO) and cryptogenic stroke. Patent foramen ovale is a remnant of the fetal circulation, found in about quarter of the general population. According to many authors, this common anatomical anomaly is of no or limited clinical significance. However, the results of some clinical studies suggest higher prevalence of PFO among subjects with either cryptogenic stroke or migraine with aura. To date, the answer to the question whether PFO is an independent risk factor for stroke remains equivocal. The purpose of this review is to discuss the role of PFO in pathophysiology of both symptomatic and asymptomatic ischaemic lesions and to analyze the coexisting factors that increase the risk of stroke. We also discuss the effectiveness of either pharmacological treatment or PFO closure in secondary stroke prevention.