Migraine in patients with Patent Foramen Ovale: is there a link? Federico Cacciapuoti 1* , Fulvio Cacciapuoti 2 1 Department of Internal Medicine, "L. Vanvitelli" University of Campania, Naples, Italy 2 Department of Cardiology, V Monaldi Hospital, Naples, Italy * Author for Correspondence: Dr. Federico Cacciapuoti, Department of Internal Medicine, L. Vanvitelli" University of Campania, Naples, Italy, email: fulvio.cacciapuoti@gmail.com Received Date: August 10, 2020, Accepted Date: August 24, 2020, Published Date: August 30, 2020 Background: PFO is a hole between right and left atrium, that is normally present in human fetus, but that sometimes persists in adulthood. Migraine is a neurological disorder frequent in adult patients having Patent Foramen Ovale (PFO). Methods and Results: A variety of clinical manifestations, such as migraine (with or without aura), TIA or cryptogenetic stroke can be present in adult patients with PFO persistence. Echographic fndings for diagnosis and percutaneous closure with an Amplazer or other devices for migraine improvement were described. Nevertheless, while some studies report a signifcant improvement of migraine after PFO closure, other trials refer uncertain or negative results on migraine symptoms after the placement of Amplazer or other devices inducing PFO closure. Conclusion: These uncertain results indicate the relationship between PFO and migraine not is clear and the evidences obtained till now testify both for causal or casual account between two events. PFO: Patent Foramen Ovale; TIA: Transient Ischemic Attack; TTE: Trans-Thoracic Echocardiography; TEE: Trans-Esophageal Echocardiography; TCDE: Trans-Cranial-Doppler Echography; LV: Left Ventricle; 5-HT:5 Hydroxy-Tryptamine; MIST: Migraine Intervention with STARfex Techonogy; PRIMA: Percutaneous closure in migraine with Aura; PREMIUM: Prospective Randomized investigation to Evaluate Incidence of headache reduction in subjects with Migraine and PFO Using the AMPLAZER PFO occlude the medical Management. Keywords: Migraine • Patent Foramen Ovale (PFO) • Right-to-left shunt • Contrast medium • Microbubbles • Amplazer or other devices Introduction Migraine is a neurological disorder, frequently marked by recurrent headache with throbbing pain interesting one side of the head that may extend to both sides. Tat usually lasts from four hours to three days. It is often accompanied by nausea, vomiting and sensitivity to light or sound, and is sometimes preceded by aura and followed by fatigue [1]. Some migraneurs will have many or all the symptoms of migraine with “aura”. Aura consists of one or more focal neurological symptoms, such as visual sensory or speech disturbances. Tis occurs in about 15-30% of migraineurs and happens shortly before a migraine attack. Tey range from seeing sparks, bright dots, and zig-zags to tingling on one side of the body or on inability to speak clearly and usually last 20-60 minutes [2]. Migraine is three-times more common in women than in men and its prevalence peaks at 40 years of age [3]. migraine are reported in Table 1 [4,5]. Patent Foramen Ovale Apart the risk factors for migraine reported in Table 1. Patent Foramen Ovale (PFO) were indicated as an important cause of migraine headaches. PFO is present more than two-fold in patients with migraine with aura in comparison to those without aura [6]. PFO is a congenital heart defect defned such as an opening in the mild portion of the interatrial septum, at the junction of the septum premium to septum secundum [7,8]. PFO is seen from subcostal view (Figure 1). Mostly, spontaneous closure occurs before the birth or in the frst two months of life. However, approximately 20-25% of healthy adults in the general population has a PFO and is asymptomatic. But, when the right atrial pressure increases more than the pressure in the left atrium, temporarily (Valsalva Review Article 10.37532/fmic.2020.12(5).670 © 2020 Interv. Cardiol. (2020) 12(5), 132-135 ISSN 1755-5302 132 Abbreviation List: Possible causes and some triggers for