美科学家发现偏头痛与动脉导管未闭之间的联系

研究人员发现：有偏头痛病史的脑卒中患者，为了治疗一种常见的叫做先天性动脉导管未闭的心脏缺陷，接受闭合手术之后，他们的偏头痛发作就会停止或者显著减轻。

PFO是心脏的一个小孔，在胚胎发育过程中是正常的，胚胎血供是由母亲肺脏氧化和供给的。尽管这个孔通常在出生后闭合，但是在人群中大约有25％这个孔没有彻底闭合，因此在成人期间PFO持续存在。这增加了本来应当循环经过肺脏的静脉血通过未成熟的动脉导管流到动脉的机会，在循环流过肺脏之前，被泵回动脉循环然后流入大脑。这种循环流入大脑的未滤过静脉血被推测触发了偏头痛的发作。

这项研究显示：患先兆偏头痛的患者具有PFO的几率是普通人群的两倍。在为期2年的研究中，研究人员检查了162例患无法解释的脑卒中样症状的患者。使用经颅超声检查系统证实了高度PFO之后，所有患者接受了导管PFO保护手术。1年的随访显示：56％患者偏头痛症状彻底消失，而14%患者声称偏头痛发作频率显著下降。

这项研究是由心脏病学家Mark Reisman医生(Swedish Medical Center, Seattle, WA, USA)主持的， 发表在2005年2月15日的《美国心脏病学院期刊》。
 
Procedure for Stroke Patients With Migraine
 
Researchers have found that stroke patients with a history of migraine headaches have had their migraines stopped or significantly reduced following a closure procedure of a common heart defect called patent foramen ovale (PFO).

PFO is a small hole in the heart, whose presence is normal during fetal development when the fetal blood supply is being enriched and oxygenated by the mother’s lungs. Although the hole usually closes shortly after birth, in about 25% of the population it fails to close completely and becomes a persistent PFO into adulthood. This opens up an opportunity for venous blood circulating through the lungs to cross over to the arterial side prematurely, before circulating through the lungs, and then to be pumped back into the arterial circulation and the brain. This unfiltered venous blood circulating in the brain is suspected of sparking a migraine.

The study showed that patients suffering from migraines with aura are twice as likely to have a PFO, compared to the general population. During a two-year period, researchers examined 162 patients who had experienced unexplained stroke-like symptoms. After confirming the presence of a high-grade PFO using a transcranial ultrasound system, all patients underwent transcatheter closure of the PFO. A one-year followup showed that 56% had complete resolution of migraine symptoms, while 14% reported a significant reduction in migraine frequency.

The study, led by cardiologist Dr. Mark Reisman (Swedish Medical Center, Seattle, WA, USA), was published in the February 15, 2005, issue of the Journal of the American College of Cardiology.