Skip to main content
  • Poster presentation
  • Open access
  • Published:

High prevalence of right to left shunt in women with chronic migraine


Prevalence of right to left shunt is estimated as 25% of the general population [1]. The prevalence of shunt has been shown to be increased in migraine with aura and one study has found a high prevalence of shunt in chronic migraine (CM) [2].


To study the prevalence of right to left shunt in a series of women with CM.


This series includes 51 women (age 44 years, range 16-63) meeting diagnostic criteria (IHC-II revised 2006)for CM. There were only 5 women with migraine with aura attacks. We carried out a transcranial doppler study (AplioXG, model SSA-790A, Toshiba) following the CODICIA study protocol [3].


Thirty patients (58.8%) showed some degree of right to left shunt. Three (60%) out of the 5 patients with migraine with aura had shunt. Thirteen patients (43%, 25 of total series) had hits during normal breathing and 17 (58%, 33% of the total series) during Valsalva maneuver. Shunt was massive in 10 patients (33%, 20% of the total series); in 9 of them shunt became massive only during the Valsalva maneuver.


Prevalence of right to left shunt in women with CM is higher than expected for the general population (1). The clinical implications of our findings need to be determined, though they suggest a relationship between the presence of shunt with an increased frequency of migraine attacks.


  1. Diener HC, et al.: . Current Opin Neurol 2007, 20: 310–319. 10.1097/WCO.0b013e328136c22d

    Article  Google Scholar 

  2. Nahas SJ, et al.: . Cephalalgia 2010, 30: 535–542.

    CAS  PubMed  Google Scholar 

  3. Serena J, et al.: . Stroke 2008, 39: 3131–3136. 10.1161/STROKEAHA.108.521427

    Article  PubMed  Google Scholar 

Download references


Support by FISSS grant PI11/00899 (ISCIII)

Author information

Authors and Affiliations


Rights and permissions

Open Access This article is distributed under the terms of the Creative Commons Attribution 2.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Reprints and permissions

About this article

Cite this article

Larrosa, D., Benavente, L., Calleja, S. et al. High prevalence of right to left shunt in women with chronic migraine. J Headache Pain 14 (Suppl 1), P105 (2013).

Download citation

  • Published:

  • DOI: