Patent foramen ovale and cerebrovascular diseases

被引:33
作者
Desai, Amish J. [1 ]
Fuller, Cindy J. [1 ]
T Jesurum, Jill [1 ]
Reisman, Mark [1 ]
机构
[1] Swedish Med Ctr, Dept Cardiovasc Res & Sci Dev, Seattle, WA 98104 USA
来源
NATURE CLINICAL PRACTICE CARDIOVASCULAR MEDICINE | 2006年 / 3卷 / 08期
关键词
cryptogenic stroke; migraine headache; paradoxical embolism; patent foramen ovale; transcatheter closure;
D O I
10.1038/ncpcardio0597
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Patent foramen ovale (PFO) has been linked to ischemic strokes of undetermined cause (cryptogenic strokes). PFO-a remnant of fetal circulation when the foramen ovale does not seal after birth-can permit microemboli to escape the pulmonary filter into the intracranial circulation, causing stroke. Coexistent atrial septal aneurysm, pelvic deep vein thrombosis and inherited clotting factor deficiencies could potentiate stroke risk in patients with PFO. Transcatheter PFO closure, a minimally invasive procedure, is one technique used to prevent recurrent cerebrovascular events. A connection between PFO and migraine headache has been conceptualized from retrospective evidence of reduced migraine frequency and severity after PFO closure; however, prospective randomized trials are needed to verify the efficacy of PFO closure on migraine prevention. In this review we discuss embryologic origins, diagnostic techniques and treatment options for prevention of paradoxical embolism thought to be related to PFO, and the relation of PTO to cryptogenic stroke and migraine.
引用
收藏
页码:446 / 455
页数:10
相关论文
共 66 条
[61]   Patent foramen ovale: Association between the degree of shunt by contrast transesophageal echocardiography and the risk of future ischemic neurologic events [J].
Stone, DA ;
Godard, J ;
Corretti, MC ;
Kittner, SJ ;
Sample, C ;
Price, TR ;
Plotnick, GD .
AMERICAN HEART JOURNAL, 1996, 131 (01) :158-161
[62]   Prognosis after percutaneous closure of patent foramen ovale for paradoxical embolism [J].
Wahl, A ;
Meier, B ;
Haxel, B ;
Nedeltchev, K ;
Arnold, M ;
Eicher, E ;
Sturzenegger, M ;
Seiler, C ;
Mattle, HP ;
Windecker, S .
NEUROLOGY, 2001, 57 (07) :1330-1332
[63]  
WEBSTER MWI, 1988, LANCET, V2, P11
[64]   Inheritance of persistent foramen ovale and atrial septal defects and the relation to familial migraine with aura [J].
Wilmshurst, PT ;
Pearson, MJ ;
Nightingale, S ;
Walsh, KP ;
Morrison, WL .
HEART, 2004, 90 (11) :1315-1320
[65]   Effect on migraine of closure of cardiac right-to-left shunts to prevent recurrence of decompression illness or stroke or for haemodynamic reasons [J].
Wilmshurst, PT ;
Nightingale, S ;
Walsh, KP ;
Morrison, WL .
LANCET, 2000, 356 (9242) :1648-1651
[66]   Comparison of medical treatment with percutaneous closure of patent foramen ovale in patients with cryptogenic stroke [J].
Windecker, S ;
Wahl, A ;
Nedeltchev, K ;
Arnold, M ;
Schwerzmann, M ;
Seiler, C ;
Mattle, HP ;
Meier, B .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2004, 44 (04) :750-758