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Who knows the pain of migraine? Probably only people who have experienced migraines know
.
When a migraine strikes, it makes people feel painful, like the end of the world, sometimes it hurts and even wants to hit the wall! Source: Redheal migraine is the most common disabling primary headache.
It often occurs in childhood, adolescence and early adulthood.
The clinical manifestations are recurrent moderate to severe headaches, which may be accompanied by nausea, vomiting, photophobia and photophobia.
Symptoms of autonomic dysfunction such as sound
.
Many people have been suffering from migraines from adolescence to old age, and they are miserable
.
More than 4 million people worldwide suffer from chronic migraine (migraine for at least 15 days a month), and more than 90% of patients cannot work normally during the attack.
The attack may last from 4 hours to 3 days
.
At present, the incidence of migraine in China is very high, reaching an annual prevalence rate of 9.
3%, of which the ratio of female to male is about 2:1, and the disease burden peaks at the age of 40 to 44
.
What causes the painful migraine? The etiology of migraine is not clear, and there are many inducing factors, such as genetic factors
.
A recent study by The Lancet showed that the heritability of migraine is about 42%
.
If the first-degree relatives have migraine, the risk of the offspring is 1.
9 to 3.
8 times that of ordinary people
.
In addition to genetic factors, hormonal factors are the most common
.
There are more women than men in the onset of migraine, and it is more prone to attacks during menstruation
.
In addition, poor sleep quality, high stress, cervical spondylosis, drugs, environmental factors (bright light, cold weather) and some dietary factors (such as wine, chocolate, cheese, coffee and preserved products, etc.
) may also cause migraines
.
Source: In addition to these common factors above, there is another factor that many people overlook
.
Some people's migraines are probably caused by "a hole in the heart", which is medically called Patent Foramen Ovale (PFO).
What is Patent Foramen Ovale? The heart is divided into four chambers
.
The upper chamber is called the right and left atrium, and the lower chamber is the right and left ventricle
.
In the fetal circulation, the foramen ovale is an opening between the left atrium and the right atrium, allowing blood to bypass the lungs and flow directly from the right atrium to the left atrium.
It is a life channel necessary for fetal development
.
Source: Mercyhealth normal people 5~7 months after birth, the foramen ovale is functionally closed.
If the foramen ovale is still not closed after 3 years of age, the remaining slit-like channel is called patent foramen ovale (PFO)
.
The length of PFO ranges from 3 to 18 mm, with an average of 8 mm, and it increases with age
.
The incidence of PFO is very high, and about one-quarter of adults have PFO
.
Under normal circumstances, blood is usually transported from the right side of the heart to the lungs to expel carbon dioxide and absorb oxygen
.
However, in patients with PFO, any short-term increase in pressure on the right side of the heart (such as straining during defecation) can open the flap for a moment, allowing blood to flow from the right atrium to the left atrium
.
When blood flows from the right atrium to the left atrium, the blood clot may move to the left side of the heart, where it is pumped into the body, including the brain
.
In the brain, blood clots can block blood flow and cause a transient ischemic attack (TIA) or stroke
.
In addition to PFO causing transient ischemic attack (TIA) or stroke, more and more data in recent years indicate that patent foramen ovale is also related to migraine.
People with migraine with aura are more likely to suffer from PFO.
The reason is speculated to be that some chemicals enter the brain circulation through the open foramen ovale and induce migraine
.
Verywellhealth, for migraine patients, how many are due to patent foramen ovale? Studies have shown that the incidence of patent foramen ovale in migraine patients is about 30-40%, and that of migraine patients with aura is as high as 48-70%
.
Will surgery to close the open foramen ovale relieve migraine? A study published in the Journal of the American College of Cardiology (JACC) in February 2021 showed that PFO closure surgery significantly reduced the average number of monthly migraine days and the number of monthly migraine attacks, and freed some subjects completely The distress of migraine, and PFO closure is safe for the treatment of migraine patients with unclosed foramen ovale
.
In this study, the authors used the results of a pooled analysis of participants' data in two randomized trials of Amplatzer PFO Occluder (PRIMA and PREMIUM) to evaluate the effectiveness of PFO closure surgery in the treatment of paroxysmal migraine with or without aura Sex and safety
.
The efficacy endpoints of the study are the reduction in the number of migraine days per month, the response rate (defined as a reduction of ≥50% in the number of migraine attacks per month), the average reduction in the number of migraine attacks per month, and those who have experienced complete cessation of migraine Percentage of patients
.
The safety endpoint is an adverse event of surgery
.
Among the 337 subjects included, 176 subjects were randomly assigned to undergo PFO closure surgery, and 161 subjects chose medication
.
During the 12-month follow-up, the researcher compiled and analyzed the comparative data of the two groups
.
The results found that for the two groups of subjects undergoing PFO closure surgery and drug therapy, the average number of migraine days per month decreased by 3.
1 days and 1.
9 days, respectively; the average number of monthly migraine attacks decreased by 2.
0 and 1.
4, respectively
.
Among the participants who underwent PFO closure, 38% had a reduction of ≥50% in the number of migraine attacks per month, compared with only 29% in the control group
.
It is worth noting that in the PFO closure surgery group, 14 patients completely got rid of migraine (9%), but in the drug group, only 1 patient got rid of migraine completely (0.
7%)
.
Within 12 months, the efficacy endpoint of foramen ovale closure surgery in the treatment of migraine and the control group.
For safety analysis, there were 9 surgery-related and 4 device-related adverse events in 245 subjects who eventually received the device.
.
But all incidents are short-lived and will eventually be resolved
.
Therefore, the study results show that PFO can significantly reduce the average number of monthly migraine days and the number of monthly migraine attacks, and enable more subjects to completely get rid of migraine headaches
.
But from the results of this study, only 9% of people get rid of migraines by PFO closure surgery.
For most people, it only reduces the number of migraine attacks and the number of days
.
Therefore, for migraine patients who have not been completely cured, even after the patent foramen ovale surgery, some other measures can be taken to relieve the migraine
.
1.
Write a migraine diary: Recording a migraine diary can screen for specific predisposing factors that cause your own migraine attacks.
After you know these predisposing factors, try to avoid them as much as possible to reduce the number of attacks
.
2.
Eat more omega-3 fatty acids: A recent study published in The BMJ shows that a diet rich in fish fat helps reduce migraines compared with participants who consume more plant-based fats and oils The number of headaches and pain intensity of the patient per month
.
The study found that compared with the control group, a diet with low vegetable oil and high fish fat reduced the total daily headache time, daily severe headache time and monthly total headache days by 30% to 40%
.
3.
Ensure adequate sleep; avoid sitting for a long time and protect the cervical spine
.
4.
Exercise more: walking, jogging, and brisk walking are all helpful
.
5.
When migraine attacks, relax and rest, and take painkillers in time
.
The earlier the painkiller is used, the better the effect
.
When the pain is too strong, the pain relief effect may become worse .
Source: Photograph.
com In summary, when migraines of unknown cause occur repeatedly, you should go to the hospital as soon as possible to seek neurology, cardiology, cardiology, and echocardiography for examination to see if it is because of the patent foramen ovale
.
PFO closure surgery can effectively relieve migraine, but blocking the foramen ovale cannot cure migraine 100%, so migraine patients still need to adjust their life>
.
Author | Jessica Editor | Jessica View the latest journal information, submission experience, click to read the original text
.
When a migraine strikes, it makes people feel painful, like the end of the world, sometimes it hurts and even wants to hit the wall! Source: Redheal migraine is the most common disabling primary headache.
It often occurs in childhood, adolescence and early adulthood.
The clinical manifestations are recurrent moderate to severe headaches, which may be accompanied by nausea, vomiting, photophobia and photophobia.
Symptoms of autonomic dysfunction such as sound
.
Many people have been suffering from migraines from adolescence to old age, and they are miserable
.
More than 4 million people worldwide suffer from chronic migraine (migraine for at least 15 days a month), and more than 90% of patients cannot work normally during the attack.
The attack may last from 4 hours to 3 days
.
At present, the incidence of migraine in China is very high, reaching an annual prevalence rate of 9.
3%, of which the ratio of female to male is about 2:1, and the disease burden peaks at the age of 40 to 44
.
What causes the painful migraine? The etiology of migraine is not clear, and there are many inducing factors, such as genetic factors
.
A recent study by The Lancet showed that the heritability of migraine is about 42%
.
If the first-degree relatives have migraine, the risk of the offspring is 1.
9 to 3.
8 times that of ordinary people
.
In addition to genetic factors, hormonal factors are the most common
.
There are more women than men in the onset of migraine, and it is more prone to attacks during menstruation
.
In addition, poor sleep quality, high stress, cervical spondylosis, drugs, environmental factors (bright light, cold weather) and some dietary factors (such as wine, chocolate, cheese, coffee and preserved products, etc.
) may also cause migraines
.
Source: In addition to these common factors above, there is another factor that many people overlook
.
Some people's migraines are probably caused by "a hole in the heart", which is medically called Patent Foramen Ovale (PFO).
What is Patent Foramen Ovale? The heart is divided into four chambers
.
The upper chamber is called the right and left atrium, and the lower chamber is the right and left ventricle
.
In the fetal circulation, the foramen ovale is an opening between the left atrium and the right atrium, allowing blood to bypass the lungs and flow directly from the right atrium to the left atrium.
It is a life channel necessary for fetal development
.
Source: Mercyhealth normal people 5~7 months after birth, the foramen ovale is functionally closed.
If the foramen ovale is still not closed after 3 years of age, the remaining slit-like channel is called patent foramen ovale (PFO)
.
The length of PFO ranges from 3 to 18 mm, with an average of 8 mm, and it increases with age
.
The incidence of PFO is very high, and about one-quarter of adults have PFO
.
Under normal circumstances, blood is usually transported from the right side of the heart to the lungs to expel carbon dioxide and absorb oxygen
.
However, in patients with PFO, any short-term increase in pressure on the right side of the heart (such as straining during defecation) can open the flap for a moment, allowing blood to flow from the right atrium to the left atrium
.
When blood flows from the right atrium to the left atrium, the blood clot may move to the left side of the heart, where it is pumped into the body, including the brain
.
In the brain, blood clots can block blood flow and cause a transient ischemic attack (TIA) or stroke
.
In addition to PFO causing transient ischemic attack (TIA) or stroke, more and more data in recent years indicate that patent foramen ovale is also related to migraine.
People with migraine with aura are more likely to suffer from PFO.
The reason is speculated to be that some chemicals enter the brain circulation through the open foramen ovale and induce migraine
.
Verywellhealth, for migraine patients, how many are due to patent foramen ovale? Studies have shown that the incidence of patent foramen ovale in migraine patients is about 30-40%, and that of migraine patients with aura is as high as 48-70%
.
Will surgery to close the open foramen ovale relieve migraine? A study published in the Journal of the American College of Cardiology (JACC) in February 2021 showed that PFO closure surgery significantly reduced the average number of monthly migraine days and the number of monthly migraine attacks, and freed some subjects completely The distress of migraine, and PFO closure is safe for the treatment of migraine patients with unclosed foramen ovale
.
In this study, the authors used the results of a pooled analysis of participants' data in two randomized trials of Amplatzer PFO Occluder (PRIMA and PREMIUM) to evaluate the effectiveness of PFO closure surgery in the treatment of paroxysmal migraine with or without aura Sex and safety
.
The efficacy endpoints of the study are the reduction in the number of migraine days per month, the response rate (defined as a reduction of ≥50% in the number of migraine attacks per month), the average reduction in the number of migraine attacks per month, and those who have experienced complete cessation of migraine Percentage of patients
.
The safety endpoint is an adverse event of surgery
.
Among the 337 subjects included, 176 subjects were randomly assigned to undergo PFO closure surgery, and 161 subjects chose medication
.
During the 12-month follow-up, the researcher compiled and analyzed the comparative data of the two groups
.
The results found that for the two groups of subjects undergoing PFO closure surgery and drug therapy, the average number of migraine days per month decreased by 3.
1 days and 1.
9 days, respectively; the average number of monthly migraine attacks decreased by 2.
0 and 1.
4, respectively
.
Among the participants who underwent PFO closure, 38% had a reduction of ≥50% in the number of migraine attacks per month, compared with only 29% in the control group
.
It is worth noting that in the PFO closure surgery group, 14 patients completely got rid of migraine (9%), but in the drug group, only 1 patient got rid of migraine completely (0.
7%)
.
Within 12 months, the efficacy endpoint of foramen ovale closure surgery in the treatment of migraine and the control group.
For safety analysis, there were 9 surgery-related and 4 device-related adverse events in 245 subjects who eventually received the device.
.
But all incidents are short-lived and will eventually be resolved
.
Therefore, the study results show that PFO can significantly reduce the average number of monthly migraine days and the number of monthly migraine attacks, and enable more subjects to completely get rid of migraine headaches
.
But from the results of this study, only 9% of people get rid of migraines by PFO closure surgery.
For most people, it only reduces the number of migraine attacks and the number of days
.
Therefore, for migraine patients who have not been completely cured, even after the patent foramen ovale surgery, some other measures can be taken to relieve the migraine
.
1.
Write a migraine diary: Recording a migraine diary can screen for specific predisposing factors that cause your own migraine attacks.
After you know these predisposing factors, try to avoid them as much as possible to reduce the number of attacks
.
2.
Eat more omega-3 fatty acids: A recent study published in The BMJ shows that a diet rich in fish fat helps reduce migraines compared with participants who consume more plant-based fats and oils The number of headaches and pain intensity of the patient per month
.
The study found that compared with the control group, a diet with low vegetable oil and high fish fat reduced the total daily headache time, daily severe headache time and monthly total headache days by 30% to 40%
.
3.
Ensure adequate sleep; avoid sitting for a long time and protect the cervical spine
.
4.
Exercise more: walking, jogging, and brisk walking are all helpful
.
5.
When migraine attacks, relax and rest, and take painkillers in time
.
The earlier the painkiller is used, the better the effect
.
When the pain is too strong, the pain relief effect may become worse .
Source: Photograph.
com In summary, when migraines of unknown cause occur repeatedly, you should go to the hospital as soon as possible to seek neurology, cardiology, cardiology, and echocardiography for examination to see if it is because of the patent foramen ovale
.
PFO closure surgery can effectively relieve migraine, but blocking the foramen ovale cannot cure migraine 100%, so migraine patients still need to adjust their life>
.
Author | Jessica Editor | Jessica View the latest journal information, submission experience, click to read the original text
