Atrial septal defect closure and migraine with aura: is there a correlation?

Recently, some authors detected increased frequency or new onset of migraine with aura (MA) after atrial septal defect (ASD) closure. We report the effects of ASD closure on the occurrence of MA in three patients of Parma Headache Centre. Two of them developed MA after the procedure one had a worsening of pre-existing MA. The increased frequency or the de novo onset of MA after ASD closure may be related to the alteration of some physiological variables that play a central role in the physiopathogenetic mechanisms of MA and may trigger attacks in predisposed individuals. In previous literature reports, the new pattern of MA appeared self-limiting within a few weeks or months. In our cases, it seemed to last longer, but the natural history of this headache subtype suggests that this finding could be related to the extended duration of our follow-up and to the prospective nature of our study.