Study of the relationship between white matter lesions in the magnetic resonance imaging and patent foramen ovale]

Introduction. Previous studies have described a higher prevalence of white matter lesions (WML) in the brain magnetic tesonance imaging (MRI) in patients with migraine. A higher frequency of right-to-left shunt (RLS) in patients with migraine with aura (MA) than in general population has been reported. This study has aimed to investigate a possible association between the existence of WML and the presence or non-presence of RLS in patients with migraine. Methods. We have reviewed migraine patients suffering MA or migraine without aura (MWA) with an MRI studied in whom left-right shunt had been determined previously by transcranial doppler (TCD). The presence of WML was determined (white matter hyperintensities in T2-weighted MR images (T2WI) and FLAIR, without signal alteration in T1WI). The presence of WML was related with the type of migraine and presence or non-presence of RLS by univariate statistics. Results. Forty four patients with migraine, 13 male and 31 female, mean age 39 years (23-66) were studied. Twelve patients had MA and 32 MWA. Fourteen patients had WML (31.8%), 29 patients (65.9%) RLS; 26.7% of the patients with WML also had RLS, and 34.5% of the patients with RLS had WML. Non-statistically significant differences were observed (p=0.738). Conclusions. We could not demonstrate a relationship between RLS and WML in the brain MRI of our patients. We do not know the nature of the association between is the association between WML and migraine, but these findings suggest that the link would not be by paradoxical embolism.