{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:34:40Z","timestamp":1786649680651,"version":"build-2736575974"},"reference-count":10,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2010]]},"abstract":"\n \n This case report describes a lady who underwent investigations as a part of a clinical study. A 32-year-old woman with a history of episodes of severe migraine with aura, deep vein thrombosis and recurrent epistaxis, presented with two episodes of stroke with no particular cause evident on routine investigations. A contrast echocardiogram demonstrated a patent foramen ovale (PFO). She was found to be positive for the Factor V Leiden mutation. The PFO was closed percutaneously. However, a substantial right to left shunt of 14% persisted. Pulmonary angiography revealed multiple arterio-venous malformations (AVMs) and she was diagnosed with hereditary hemorrhagic telangiectasia. The AVMs were embolized and she has had no further cerebral events. Interestingly, her episodes of 'migraine' have also improved dramatically following the closure of the PFO and the embolization of the AVMs. This case demonstrates the complex relationship between right to left shunts, cryptogenic stroke and migraine.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/0022-3859.68630","type":"journal-article","created":{"date-parts":[[2010,8,23]],"date-time":"2010-08-23T06:08:48Z","timestamp":1282543728000},"page":"206-208","source":"Crossref","is-referenced-by-count":7,"title":["Paradoxical embolism causing stroke and migraine"],"prefix":"10.4103","volume":"56","author":[{"given":"S","family":"Nightingale","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"GS","family":"Ray","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-9-20240205","doi-asserted-by":"crossref","first-page":"959","DOI":"10.1212\/WNL.55.7.959","article-title":"Pulmonary arteriovenous malformations: Cerebral ischemia and neurologic manifestations","volume":"55","author":"Moussouttas","year":"2000","journal-title":"Neurology"},{"key":"R2-9-20240205","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1111\/j.1526-4610.1993.hed3303145.x","article-title":"An association between migrainous aura and hereditary haemorrhagic telangiectasia","volume":"33","author":"Steele","year":"1993","journal-title":"Headache"},{"key":"R3-9-20240205","doi-asserted-by":"crossref","first-page":"1172","DOI":"10.1212\/WNL.55.8.1172","article-title":"Interatrial septal abnormalities and stroke: A meta-analysis of case-control studies","volume":"55","author":"Overell","year":"2000","journal-title":"Neurology"},{"key":"R4-9-20240205","doi-asserted-by":"crossref","first-page":"706","DOI":"10.1161\/hs0302.104543","article-title":"Clinical and imaging findings in cryptogenic stroke patients with and without patent foramen ovale: The PFO-ASA Study: A trial Septal Aneurysm","volume":"33","author":"Lamy","year":"2002","journal-title":"Stroke"},{"key":"R5-9-20240205","doi-asserted-by":"crossref","first-page":"2625","DOI":"10.1161\/01.CIR.0000017498.88393.44","article-title":"Effect of medical treatment in stroke patients with patent foramen ovale: Patent foramen ovale in Cryptogenic Stroke Study","volume":"105","author":"Homma","year":"2002","journal-title":"Circulation"},{"key":"R6-9-20240205","doi-asserted-by":"crossref","first-page":"1740","DOI":"10.1056\/NEJMoa011503","article-title":"Recurrent cerebrovascular events associated with patent foramen ovale, atrial septal aneurysm, or both","volume":"345","author":"Mas","year":"2001","journal-title":"N Engl J Med"},{"key":"R7-9-20240205","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/S0002-8703(00)90322-3","article-title":"Low incidence of embolic strokes with atrial septal aneurysms: A prospective, long-term study","volume":"139","author":"Burger","year":"2000","journal-title":"Am Heart J"},{"key":"R8-9-20240205","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/S0025-6196(12)60336-X","article-title":"Incidence and size of patent foramen ovale during the first 10 decades of life: An autopsy study of 965 normal hearts","volume":"59","author":"Hagen","year":"1984","journal-title":"Mayo Clin Proc"},{"key":"R9-9-20240205","doi-asserted-by":"crossref","first-page":"1622","DOI":"10.1212\/WNL.52.8.1622","article-title":"Potential source of cerebral embolism in migraine with aura: A transcranial Doppler study","volume":"52","author":"Anzola","year":"1999","journal-title":"Neurology"},{"key":"R10-9-20240205","doi-asserted-by":"crossref","first-page":"1397","DOI":"10.1161\/CIRCULATIONAHA.107.727271","article-title":"Migraine Intervention With STARFlex Technology (MIST) trial: A prospective, multicenter, double-blind, sham-controlled trial to evaluate the effectiveness of patent foramen ovale closure with STARFlex septal repair implant to resolve refractory migraine headache","volume":"117","author":"Dowson","year":"2008","journal-title":"Circulation"}],"container-title":["Journal of Postgraduate Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/00005257-201056030-00009","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T18:56:58Z","timestamp":1786647418000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/00005257-201056030-00009"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010]]},"references-count":10,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2010]]}},"URL":"https:\/\/doi.org\/10.4103\/0022-3859.68630","relation":{},"ISSN":["0022-3859"],"issn-type":[{"value":"0022-3859","type":"print"}],"subject":[],"published":{"date-parts":[[2010]]}}}