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    MIGRAINE AND PATENT FORAMEN OVALE - CASE REPORT
    (Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, 2023)
    Deleva Stoshevska, Tatjana
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    Nikoloska, Sofija
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    Nikoloski, Marko
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    Stoshevski, Bojan
    AbstractMigraine is a headache disorder, typically characterized by unilateral headache (with or without aura) of pulsating quality, which is associated with nausea, phonophobia and photophobia. The patent foramen ovale (PFO) is a remnant of the fetal circulation. Multiple studies suggest that migraine is more prevalent in subjects with PFO and vice versa, suggesting that PFO and migraine may be risk factors for each other.Case report.We present a 33-year-old female patient with unilateralhemicranialheadache,mostly on the right side, pain in the right eye, nausea, vomiting, photo and phonophobia, with previous visual difficulties with the ipsilateral eye. The complaints usually lasted2-3 days and wereassociatedmostly with the menstrual cycle. Therewerealso occasional bouts of dizziness. Ophthalmological and otorhinolaryngological nature of these complaints wasexcluded with additional investigations. In addition, nuclear magnetic resonance (NMR)of the brain, color Doppler duplex sonography(CDDS)of carotid and vertebral arteries were performed, all with normal findings. On transcranial color Doppler sonography with Bubble test, a positive finding was obtained for a Grade 4 right-left shunt and the patient was referred for cardiology assessment and evaluation. The patient was diagnosed with migraine with aura (visual) and PFO.Conclusion.Results from epidemiological studies examining the relationship between PFO and migraine are mixed at best. It is unclear if there is a causal relationship or simply a co-existence of these two conditions. Moreresearch of PFO in migraine is clearly needed before we can consider changing our views on the aforementioned conclusions.Keywords:migraine, patent foramen ovale.
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    Clinical significance of the vertebral artery hypoplasia
    (Macedonian Association of Anatomists and Morphologists, 2013)
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    Because of their anatomical localization, vertebral arteries were neglected in research for a long period of time. Vertebral arteries are responsible for about 30% of the brain blood supply. The aim of this study was to analyze the normal and variable dimensions of the vertebral artery size such as hypoplasia and aplasia, and to emphasize the clinical importance of these congenital variations. For the purpose of this study we examined radiographs of 30 patients who had CT angiography undertaken for a variety of clinical reasons, performed as a part of their medical treatment at the University Clinic for Radiology in Skopje, R. Macedonia. We analyzed CT reports for the diameter of the vertebral artery. The diameter of the left vertebral artery was from 1.6-5.20 mm, average 3.35 mm. The diameter of the right vertebral artery was from 1.64-5.40 mm, average 3.19 mm. Hypoplasia of the vessel was found in four patients. We found no aplasia of the vessel in this series. Vertebral artery hypoplasia is common in the Macedonian population and can be reliably diagnosed on CT scans. Our study has highlighted the clinical significance of vertebral artery hypoplasia in stroke and migraine.