J Korean Ophthalmol Soc.  2016 Nov;57(11):1817-1820. 10.3341/jkos.2016.57.11.1817.

A Case of Migraine with Aura Related to the Percutaneous Closure of Atrial Septal Defect

• Yeo JH
• Kim SW
• Chun YS

• KMID: 2357743
• DOI: http://doi.org/10.3341/jkos.2016.57.11.1817

Abstract

PURPOSE
To report a case of migraine attacks with aura that occurred after percutaneous closure of an atrial septal defect (ASD) with the Amplatzer septal occluder device.
CASE SUMMARY
A 58-year-old female presented with glare and scintillation that lasted 3 days. She had a history of percutaneous ASD intervention 3 weeks prior. Because ophthalmologic examination revealed nothing remarkable, the patient underwent observation. However, two months later, she revisited our department, presenting with aggravated glare, scintillation, and severe photophobia. Also, she presented with scintillation followed by a headache starting from the right temporal area extending to the occipital area. The patient was diagnosed with migraine with aura, which was newly developed after percutaneous ASD closure. After switching medication from acetylsalicylic acid to clopidogrel, the frequency and intensity of the headaches were reduced. No recurrence of ophthalmic symptoms or headache was observed during the 1-year follow-up.
CONCLUSIONS
Percutaneous closure of ASD can be complicated by the appearance of migraine attacks with aura. When patients present with glare and scintillation, ophthalmologists must consider the possibility of migraine with aura and migraine induced by secondary causes. Thus, detailed history taking should be taken in order to make an early diagnosis of migraine.

Keyword

Atrial septal defect; Migraine with aura

MeSH Terms

Aspirin
Early Diagnosis
Epilepsy
Female
Follow-Up Studies
Glare
Headache
Heart Septal Defects, Atrial*
Humans
Middle Aged
Migraine Disorders*
Migraine with Aura*
Photophobia
Recurrence
Septal Occluder Device
Aspirin

Figure

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  Figure 1. A carotid ultrasonography of left carotid bulb. An ultrasonographic image showed stenosis of carotid bulb (white arrow).

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  Figure 2. An Atrial septal occluder device (AMPLATZER™). It is self-expanding double-disk device made of a nitinol (nickel titanium) wire mesh.

Reference

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