AUTHOR=Leger Charles Stevens , DeSouza Joseph F. X. 

TITLE=Migraine Modulation and Debut after Percutaneous Atrial Septal Defect Closure: A Review

JOURNAL=Frontiers in Neurology

VOLUME=8

YEAR=2017

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2017.00068

DOI=10.3389/fneur.2017.00068

ISSN=1664-2295

ABSTRACT=<sec id="ST1"><title>Introduction</title><p>Change in migraine headache (MH)—preexisting MH change or development of <italic>de novo</italic> MH—are known potential complications following percutaneous closure of atrial septal defect (ASD), but consensus on a causal trigger remains elusive.</p></sec><sec id="ST2"><title>Objectives</title><p>To expose potential MH triggers linked, mainly by timing and occurrence, to the emergence of <italic>de novo</italic> MH or change in preexisting MH subsequent to percutaneous ASD closure (pASDC).</p></sec><sec id="ST3"><title>Methods</title><p>The literature was systematically searched for studies available in English reporting MH status after pASDC published between January 1, 1990 and November 15, 2015. We determined the number and percentage of patients experiencing MH status change within 7 days post procedure and the cumulative total by final follow-up (Mdn = 12 months).</p></sec><sec id="ST4"><title>Results</title><p>Twenty-five studies met the inclusion criteria, which accounted for a total of 1,646 pASDC patients. Pre-procedure MH prevalence was 8% (126/1,646). Change in preexisting MH occurred in a total of 72% (91/126), 12% (11/91) within 7-days after pASDC; within follow-up MH improved in 14% (18/126), resolved in 37% (47/126), but persisted in 63% (79/126). <italic>De novo</italic> MH incidence ranged between 10 (153/1,520) and 18.3% (153/836); 34% incipience (52/153) was within 7-days of pASDC; females accounted for 80% (63/79) of gender differentiated cases; of type distinguished cases, 42% (51/122) were MH without aura (MO) and 58% (71/122) were MH with aura (MA); MH improved in 10% (16/153), resolved in 24% (37/153) but persisted beyond final follow-up in 76% (116/153). Antiplatelet agents were effective modulators of MH in 44% (11/25) studies. Possible adverse MH-predisposing traits were scarce: larger ASD size reported in ~2% (39/1,646) of patients experiencing <italic>de novo</italic> MH or preexisting MH exacerbation; short aortic rim reported in three <italic>de novo</italic> MH patients; allergic response to occluder nickel alloy in four patients with MH status change from baseline (<italic>de novo</italic> or preexisting MH change not specified).</p></sec><sec id="ST5"><title>Interpretation</title><p>Early intensification of MH status change but later amelioration (virtually paralleling stages of endothelialization), relatively high efficacy of antiplatelet agents, and the emergence of MA as the dominant <italic>de novo</italic> MH type favor proinflammatory triggers of MH status change after pASDC.</p></sec>