Can Heart Surgery Help Migraines?

June 23, 2005 — -- At a major migraine conference in Philadelphia this week, researchers discussed a dramatically new approach to preventing the debilitating headaches.

An estimated 28 million Americans suffer from migraines -- a pain so intense it leaves people unable to function for hours, even days. Now, some doctors say they may have found a cure that involves fixing the heart.

Migraine headaches often left Nancy Buie immobilized with pain. But doctors had no idea what to do about it until she had a series of mild strokes.

"Excruciating," she said. "Usually I would be very sick to my stomach. I wouldn't eat anything, couldn't eat anything. I would just be incapacitated. Just go to bed, turn the lights out, shut the curtains."

Doctors discovered that Buie, like millions of Americans, had a hole between the right and left side of her heart. It allowed tiny clots to pass out of the heart, through the body, and up to the brain where they can cause a stroke. Now, some doctors say that same clotting material from the heart may be a common cause of migraines.

"The brain of a migraine sufferer is hyper-excitable, we believe," said Dr. David Dodick, director of the Mayo Clinic's Headache Program in Scottsdale, Ariz. "And if that material goes to the brain, it could trigger a cascade of events in the brain that could lead to a migraine attack."

When doctors sealed the hole in Buie's heart, it not only prevented further strokes, it actually cured her of her migraines. In preliminary studies, about half of all migraine sufferers who've had the procedure report their headaches stopped, once and for all.

"I personally believe this is going to be an extraordinarily powerful treatment for patients who have migraine headaches," said Dr. Jonathan Tobis, director of the UCLA Interventional Cardiology Research program.

The procedure is relatively simple and minimally invasive. Doctors thread a collapsible mesh plug through a vein in the leg and up to the heart, where it expands into place and seals the hole. The whole procedure takes just 45 minutes under local anesthesia.