A heart procedure may help some patients with severe migraine, doctors reported yesterday.
The study is claimed as the first to show the procedure – closure of a slight opening in the heart – can work for patients who have not previously suffered stroke or mini-strokes.
Experts say it is still too early to say how many migraine patients might benefit.
Some 80 migraine patients in Italy volunteered to take part in a trial, with some of them agreeing to undergo the procedure known as closure of the patent foramen ovale, a slight opening between the left and right <!atria> sides of the heart.
As many as one in four people retain this feature of the heart after birth.
They had been identified as possible beneficiaries through brain scans that searched for minor and previously undetected damage.
The results are reported in the journal JACC: Cardiovascular Interventions.
Writing in the journal a British expert Dr Peter Wilmshurst, of the Royal Shrewsbury Hospital, Shropshire, said: "We don’t really know what’s going on. A stroke could be caused if a blood clot passes across a patent foramen ovale and travels to the brain, but with migraine we don’t yet know what the trigger substance is that crosses the shunt.
"Not everyone with migraine has a patent foramen ovale, and not everyone with a PFO has migraine; there are other causes that we don’t yet understand."
The patients in the study were found to have "silent" lesions on the brain when examined by MRI scanners.
Researcher Dr Carlo Vigna, of Casa Sollievo della Sofferenza IRCCS Hospital, San Giovanni Rotondo, Italy, said the patients in the study were not known to have suffered stroke <!cerebral ischaemia> but showed signs of sub-clinical brain lesion.
He said: "The study suggests closure of a large patent foramen ovale may improve migraine in patients with subclinical brain lesions, as well as those with prior stroke."
J Am Coll Cardiol Intv, 2009; 2:107-113, doi:10.1016/j.jcin.2008.10.011
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