Headaches in children after transcatheter device closure of atrial septal defects: a single centre experience
Bibliographic record
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.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".