| Objective:To investigate the relationship between migraine and Patent Forame-n Ovale(PFO)through compare the incidence of PFO beween migraine patients and normal people,and to evaluate the effect of percutaneous closure in migr-aine people with PFO through the follow-up and evaluation of the degree of headache relief in migraine patients with PFO who received the treatment of percutaneous closure.Methods:This study chose 200 cases between January 2015 and May 2017 in Department of neurology,Affiliated Hospital of Hubei Minzu University which were diagnosed with migraine,and the diagnostic criteria is according to The International Classification of Headache Disorders,3rd edition(ICHD-3).Mean-while,200 normal people who came to the hospital for physical examination during the same period were selected as the control group.General information of the subjects in the two groups,such as gender,age,smoking history,drink-ing history and family history was recorded in detail,and the general informat-ion of the subjects in the two groups was compared.Subseqently,transthoracic echocardiography(TTE)and c-TTE,transcranial doppler sonography(TCD)and c-TCD were used to compared the incidence of the PFO in the two groups.74patients diagnosed with PFO and meeting the inclusion criteria for PFO closure were transferred to the Department of cardiology,and treated with percutaneous PFO closure under local anesthesia.Routine X-ray and echocardiography were used for guidance during closure.The cardiogram was reviewed immediately a-fter closure.TTE was reviewed 1 month after the closure,TTE and c-TTE w-ere reviewed 6 months after the closure to determine the residual shunt,and CT was reexamined for new infarcs.Visual analogue scale(VAS),Migraine Di-sability Assessment questionnaire(MIDAS),Headache Impact Test-6(HIT-6)were assessed preoperatively 1 month,3 mmoths,6 months and 12 months after the closure,and then were compared with those before the closure.Results:1.The incidence of PFO in the observation group and the control gr-oup was 47.5%and 18.5%respectively,it was higher in the observation group than that in the control group(X~2=38.037,P<0.05),and the difference was s-tatistically significant.2.Of the 74 patients who underwent PFO closure,2 w-ere not occluded successfully.Among the 72 patients with successful closure,1patient had postoperative palpitations,which improved after symptomatic treat-ment,and the rest did not have complications.3 patients lost follow-up 1 mo-nth after the closure.The TTE reexamination at 1 month after the closure sho-wed that the blockage was in good position,reexamination of TTE at 6 mont-hs after the closure was conducted,and c-TTE was used to determined the re-sidual shunt,it was suggested that there were still 7 patients with shunt,inclu-ding 1 patients with moderate shunt and 6 patients with small shunt.Reexami-nation of Computed Tomography(CT)showed no new infarct lesions.Follow-up results:The VAS score at 1 month(5.36±0.98),3 months(3.74±0.99),6 months(2.33±0.95),12 months(1.19±0.87)after closure compared with the be-fore(6.81±1.14)were all lower,the difference was statistically significant(P<0.05).The HIT-6 score at 1 month(53.32±2.01),3 months(49.48±2.58),6 mont-hs(44.26±3.63),12 months(39.28±2.98)after closure compared with the befo-re(56.20±2.44)were all lower,the difference was statistically significant(P<0.05).The MIDAS score at 1 month(16.10±2.76),3 months(10.99±2.73),6 mo-nths(6.16±2.58),12 months(2.68±2.03)after closure compared with the before(20.35±3.00)were all lower,the difference was statistically significant(P<0.05).Conclusion:1.The incidence of PFO in migraine patients is higher than that in normal population,and PFO with Right-to-Left shunt(RLS)may be one of the causes of migraine.2.PFO closure is effective for migraine and can cure or relieve headache symptoms in migraine patients with PFO. |
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