Clinical Correspondence

Department of Neurology

Simulation General Hospital

Longheath Road

Mountainview

Simshire SI4 UON

​

Date: 13th November 2020

​

Morgan Blake

13.12.1995

16 Gumtree Avenue

Granville

GR5 6LK

​

 

Dear GP Colleague,

​

Diagnoses:

1. Migraines

2. Patent foreman ovale echocardiogram

​

It was a pleasure to review Morgan Blake in Stroke clinic today. Morgan had experienced a sudden onset word-finding difficulty in September 2020 when at a restaurant. This was preceded by some brief visual disturbance in the right side of the vision. The speech difficulties lasted 5 minutes with full resolution. There was a mild frontal headache afterwards, but no photophobia or nausea.

​

Morgan has a history of headaches which sound migrainous. Morgan has previously had severe headaches where she needs to lie down in a dark room. Morgan has never had headaches associated with speech change or weakness of the limbs.

​

Morgan was seen in TIA clinic shortly after and went on to have a normal MRI scan and normal carotid dopplers. The given diagnosis was migraine.

​

Morgan Blake also went on to have an echocardiogram, which showed a structurally normal heart but suspicion of patent foreman ovale. Morgan then had a bubble echocardiogram in October 2020 which confirmed a large PFO.

​

Morgan was discussed at the PFO MDT but without evidence of ischaemic event and history suggestive of migraine we elected not to refer for closure.

​

​

Kind regards,

​

Prof Piers Faberge-Smith

Consultant Neurologist

​