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To the Editor:We have read with interest the article recently published in Stroke , “Shunt-associated migraine responds favorably to atrial septal repair”, by Anzola and colleagues.1 In their study, the authors focus on migraine course after transcatheter closure of patent foramen ovale (PFO). After a 12-month follow-up, patients who had undergone PFO closure showed a significant reduction in migraine frequency as compared with controls. This study adds to previous findings showing efficacy of PFO closure on migraine outcome in different populations.2–5However, some possible confounding factors might have partially influenced the results of these studies. For instance, …

Migraine Relief After Patent Foramen Ovale Closure: Should Vascular Risk Factor Control Be Achieved First?