Severe Migraine Associated With Nickel Allergy Requiring Surgical Removal of Atrial Septal Device.

Few patients experience migraines after transcatheter closure of secundum atrial septal defects with nitinol devices. These migraines are usually treated with analgesics and resolve after a few months as the device endothelializes. This report describes the case of a 16-year-old male patient who required surgical explantation of the device 6 years after closure because of debilitating headaches. He had a grade 1 reaction to nickel after skin testing. Intraoperatively, the device had not fully endothelialized. Immediately after removal of the device, his headaches completely resolved. Long-term nickel allergy may cause severe migraine secondary to a lack of endothelialization of a device. Patients with extreme cases may require surgical removal of the device.