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J Headache Pain. 2009 Aug;10(4):303-6. doi: 10.1007/s10194-009-0125-3. Epub 2009 May 7.

A case of atypical sporadic hemiplegic migraine associated with PFO and hypoplasia of vertebro-basilar system.

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  • 1Department of Clinical Neurosciences, University of Palermo, Palermo, Italy.


We describe the case of a patient with atypical hemiplegic migraine and associated basilar symptoms, where a large patent foramen ovale (PFO) and hypoplasia of basilar artery were found. The longer period of 4-year remission of the headache attacks was coincident with the percutaneous PFO closure. When 5 years after, hemiplegic migraine attacks relapsed, with more relevant basilar symptoms, a mild re-opening of PFO was found. The atypical presentation of attacks with basilar symptoms and prolonged hemiplegia does not strictly fit the diagnostic criteria of ICHD-II.

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