| Background and ObjectiveMigraine is a common episodic neurovascular disorder, characterized by episodic, mostly unilateral, and moderate to severe headache. The typical migraine headache is unilateral (affecting one half of the head) and pulsating in nature and lasting from 4 to 72 hours; accompanied by symptoms including nausea, vomiting, photophobia (increased sensitivity to light), phonophobia (increased sensitivity to sound); migraine may can aggravate after activity, and relieve after a rest in a quiet environment. Migraine has a high incidence, recurrence and delayed healing, as well as a delibilating attack, which undoubtedly does harm to the health of patients, and has a a negative impact on the quality of life of patients. World Health Organization (WHO) regards a severe migraine as a serious disabling disease.Most scholars of migraine focus on the vascular and immunology system when they study the pathophysiology and hypothesis of of migraine; while recently some scholars have proposed a hypothesis that congenital heart disease(CHD) has certain relationship with migraine and CHD may serve as a risk factor of migraine. More and more studies showed that congenital heart disease may induce migraine, and especially, patent foramen ovale was associated with migraine. Primary and secondary oval fossa fail to properly form the natural adhesion of fusion, but leave a small fracture, which is known as the foramen ovale; the closure of foramen ovale occurs within 1 year after birth, mostly in the form of the functional closure. If the foramen ovale is still not closed after 3 years old, it is called PFO (patent foramen ovale).When there is a chronic increase of right atrial pressure or a sudden increase of right atrial pressure, it exceeds left atrial pressure, resulting in the separation of the weak primary valve on the left, followed by the emergence of right to left shunt. At the same time, various types of venous emboli go through the patent foramen ovale into the left atrium, and into the systemic circulation, resulting in anomalous embolization in cerebral arteries and (or) other arteries. The study included 12 patients with migraine, and cardiac ultrasound examination revealed patent foramen ovale and bicuspid aortic valvular deformation. This study aims to study the relationship between CHD and pain intensity of migraine, to explore the correlation between different types of migraine and patent foramen ovale & bicuspid aortic valvular deformation. Meanwhile, comparison of age and sex of patients with migraine was made and finally the relationship between CHD and migraine were explored.Methods503 patients came to Department of Neurology, Peking University Shenzhen Hospital, with complaint of "headache" from January 2010 to February 2011. All the patients underwent cardiac ultrasonography, of whom 9 patients were found patent foramen ovale, and 3 patients bicuspid aortic valvular deformation, and all were diagnosed as migraine according to IHS (International Headache Society) classification of migraine and diagnostic criteria for headache. SPSS13.0 (Statistical Package for the Social Science, SPSS) was applied for statistical analysis. Data was presented as mean±standard deviation ( x±SD).ResultsThe main clinical manifestation of 12 patients is that patients with the average age of 33.4±5.40 years-old showed recurrent headaches, presenting with unilateral pulsating headache, lasting 2-72h, with the average duration of disease 19.9±6.52 years. When severe migraine occurred, it may be associated with severe nausea and vomiting.There were 3 patients with aura before the headache. Echocardiography revealed 9 patients with patent foramen ovale and 3 with bicuspid aortic valvular deformation.ConclusionMigraine may have a certain correlation with congenital heart disease, migraine may be treated through the treatment of congenital heart disease. But there are still shortcomings, we collected a relatively small number of cases. It remains further study in large sample. |
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