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• Vol.53 No.8
• CLINICA NEUROL, 53: 638−641, 2013
• Vol.53 No.8 contents

Brief Clinical Note

A case of migraine with aura attenuated by transcatheter closure of atrial septal defect

Jun Tanaka, M.D.¹⁾, Yusuke Yakushiji, M.D.¹⁾, Yusuke Nanri, M.D.¹⁾, Masataka Kajiwara, M.D.²⁾, Kenji Suda, M.D.³⁾ and Hideo Hara, M.D.¹⁾

¹⁾Division of Neurology, Department of Internal Medicine, Saga University Faculty of Medicine
²⁾Department of Cardiology, Department of Internal Medicine, Saga University Faculty of Medicine
³⁾Department of Pediatrics and Child Health, Kurume University School of Medicine

A 38-year old man with an 8-year history of migraine with subclinical abnormal brain lesions on MRI was admitted to our hospital. His migraine attacks followed visual disturbance or dysarthria. Brain MRI revealed old infarctions restricted to the posterior circular region. On transesophageal cardiography, an atrial septal defect (ASD) was detected, and a bubble study showed an immediate appearance of many bubbles in the left atrium via ASD without Valsalva maneuver. The bubble study on transcranial-color-flow imaging also detected micro-embolic signals at the left vertebral artery and the left middle cerebral artery without Valsalva maneuver. Since paradoxical embolism via ASD was highly suspected and Qp/Qs was more than 1.5, transcatheter closure of ASD using AMPLATZER® Septal Occluder was performed. At a 2-year follow up, no recurrence of either migraine or infarction was found. This case indicates the relevance of right-to-left shunt to migraine with aura, as well as the usefulness of transcatheter closure of ASD using AMPLATZER® Septal Occluder for treatment of migraine with aura.
Full Text of this Article in Japanese PDF (4705K)

(CLINICA NEUROL, 53: 638−641, 2013)
key words: migraine, stroke, atrial septal defect, RL shunt, septal closure

(Received: 13-Oct-12)