This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
Abstract
Objective: To determine if embolization of pulmonary arteriovenous malformations (PAVMs) decreases the occurrence of migraine.
Methods: All 105 patients with hereditary hemorrhagic telangiectasia (HHT), minimum age 16 years, who underwent an embolization of PAVM in our hospital between June 1995 and April 2004, were included in this study. A structured headache questionnaire was sent to all patients and focused on two periods: 1 year before and at least 6 months after embolization. Two independent neurologists diagnosed migraine according to the International Headache Society criteria.
Results: Eighty-four patients (80%) sent back the questionnaire (mean age 47.8 ± 15.1 years, 51 female). Median follow-up time was 48 months (first quartile: 23 months; third quartile: 66 months). The overall prevalence of migraine decreased from 45.2% before to 34.5% after embolization (p = 0.01). The prevalence of migraine with aura decreased from 33.3% before to 19.0% after embolization (p = 0.002). The severity of headache attacks decreased in patients who still had migraine (p = 0.15) or migraine with aura after embolization (p = 0.11).
Conclusion: Embolization of pulmonary arteriovenous malformations in patients with hereditary hemorrhagic telangiectasia seems to be related to a decrease in prevalence of migraine, suggesting that the presence of a right-to-left shunt rather than the localization of this shunt plays a causative role in the pathogenesis of migraine.
AAN Members
We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.
AAN Non-Member Subscribers
Purchase access
Letters: Rapid online correspondence
REQUIREMENTS
You must ensure that your Disclosures have been updated within the previous six months. Please go to our Submission Site to add or update your Disclosure information.
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.
You May Also be Interested in
Topics Discussed
Alert Me
Recommended articles
Prevalence and size of directly detected patent foramen ovale in migraine with aura
Potential source of cerebral embolism in migraine with aura
Percutaneous closure of patent foramen ovale reduces the frequency of migraine attacks
Systemic right-to-left shunts, ischemic brain lesions, and persistent migraine activity