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Different degrees of right-to-left shunting predict migraine and stroke: Data from 420 patients

From the Servizio di Neurologia, Ospedale S. Orsola FBF, Associazione Fatebenefratelli per la Ricerca (AFaR), Brescia, Italy (G.P.A.); Clinica Neurologica Università di Brescia, Brescia, Italy (E.M.); and Divisione di Cardiologia I, Humanitas Gavazzeni, Bergamo, Italy (F.C., E.O.).

Address correspondence and reprint requests to Dr. Gian Paolo Anzola, Servizio di Neurologia, Ospedale S. Orsola FBF, Via Vittorio Emanuele II, 27, 25100 Brescia, Italy; e-mail: gpanzola{at}numerica.it

The authors analyzed the extent of right-to-left shunting in patients with migraine, patients with cryptogenic stroke, and controls. Patients with both migraine and stroke had larger shunts than did patients with migraine without stroke (p = 0.038), patients with no migraine with stroke (p = 0.007), and control patients (p < 0.0001). Patients with migraine have overall larger shunts than nonmigraineurs, particularly if they have had a stroke. Right-to-left shunting may be causally related to migraine and to the increased stroke risk of migraine.

Disclosure: The authors report no conflicts of interest.

Received June 27, 2005. Accepted in final form November 28, 2005.

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