Abstract

The prevalence of migraine with aura in the general population is 12%, but was 3.5 times higher(42%) in patients with right-to-left shunt caused by patent foramen ovale, atrial septal defect, or pulmonary arteriovenous malformations. Many studies have reported the efficacy of percutaneous closure of shunt for reducing the prevalence of migraine with aura. However, a recent prospective controlled study did not show the efficacy of percutaneus shunt closure as a treatment of migraine. There are still many debating issues about this topic. The author would review that association of right-to-left shunt to migraine, relating phathophysiological mechanisms, and management of shunts in migraneurs.