Headaches in children after transcatheter device closure of atrial septal defects: a single centre experience

Abstract

Abstract Background Transcatheter device closure (TDC) is the most common treatment for isolated atrial septal defects (ASD) in children. In the adult population, the incidence of new-onset migraine headache after TDC is well-recognized, and is estimated at 15%. New-onset headache has not been well-described in an exclusively pediatric population. We reviewed our center’s experience to estimate the rate of headache complaints among pediatric patients undergoing TDC. Methods We performed a single-center retrospective review of all children undergoing TDC between January 1, 2018 and December 31, 2021. Among included patients, we comprehensively reviewed the electronic medical record (EMR), to identify patients reporting headache. Results 165 consecutive patients underwent TDC during the study period. Of these, 134 met inclusion criteria. 20 (14.9%) patients had headache documented in the EMR. Of those, 7 (7/134, 5%) had persistent headaches (lasting greater than four weeks) or required further investigations. Two patients had headaches that were investigated with a brain MRI, which demonstrated normal or non-specific findings. One patient with a prior history of migraine required admission to hospital for migraine exacerbation. Another required emergency room management for status migrainosus. In addition to symptomatic pain management, 3 patients had a change in their anti-platelet regimen changed to clopidogrel. All patients with persistent headache were female (p < 0.1). Conclusions Our study demonstrated persistent headaches in 5% of children who underwent TDC. It is important for practitioners to discuss this association prior to TDC. Determination of the true incidence will require focused prospective data collection.