Patent foramen ovale (PFO) and stroke: clinical features

Epidemiology of PFO and stroke

• PFO is present in 30% of the population
• PFO is detected in >50% of young cryptogenic stroke
• PFO is detected in about 80% of people with migraine who develop stroke
• PFO is prevalent in older people with cryptogenic stroke
• People >60 years accounted for 60% of PFO cases in one review

Predictors of stroke with PFO

Predictors of recurrent stroke with PFO

Medical treatment

References

1. Messe SR, Silverman IE, Kizer JR, et al. Practice Parameter: Recurrent stroke with patent foramen ovale and atrial septal aneurysm: Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 2004; 62:1042-1050.
2. Kernan WN, Ovbiagele B, Black HR, et al. Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2014; 45:2160-2236.
3. Dowson A, Mullen MJ, Peatfield R, et al. 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. Circulation 2008; 117:1397-1404.
4. West BH, Noureddin N, Mamzhi Y, et al. Frequency of patent foramen ovale and migraine in patients with cryptogenic stroke. Stroke 2018; 49:1123-1128. 
5. Mazzucco S, Li L, Binney L, Rothwell PM; Oxford Vascular Study Phenotyped Cohort. Prevalence of patent foramen ovale in cryptogenic transient ischaemic attack and non-disabling stroke at older ages: a population-based study, systematic review, and meta-analysis. Lancet Neurol 2018; 17:609-617.
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Related checklists

• Patent foramen ovale (PFO) and migraine
• Patent foramen ovale (PFO) and stroke: PFO closure