Migrating lumbar intrathecal catheter fragment associated with intracranial subarachnoid hemorrhage
| Autor: | Hatem Sabry, Neil Roundy, Jesse J. Liu, Luke Hnenny, Aclan Dogan, Jeffrey S. Raskin |
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| Rok vydání: | 2014 |
| Předmět: |
Male
medicine.medical_specialty Subarachnoid hemorrhage Catheters Photophobia Nausea Lumbar Foreign-Body Migration Vertebrobasilar Insufficiency Medicine Humans Foramen Magnum Failed Back Surgery Syndrome Injections Spinal Aged Neck pain Lumbar Vertebrae Morphine business.industry General Medicine Infusion Pumps Implantable Silastic Subarachnoid Hemorrhage medicine.disease Surgery Analgesics Opioid Catheter Anesthesia medicine.symptom Presentation (obstetrics) business Tomography X-Ray Computed |
| Zdroj: | Journal of neurosurgery. Spine. 22(1) |
| ISSN: | 1547-5646 |
| Popis: | Intrathecal catheter placement into the lumbar cistern has varied indications, including drug delivery and CSF diversion. These Silastic catheters are elastic and durable; however, catheter-associated malfunctions are well reported in the literature. Fractured catheters are managed with some variability, but entirely intradural retained fragments are often managed conservatively with observation. The authors describe a case of a 70-year-old man with an implanted intrathecal morphine pump for failed back surgery syndrome who presented to an outside hospital with a history of headache, neck pain, nausea, and photophobia of 3 days' duration. He also described mild weakness and intermittent numbness of both legs. Unenhanced head CT demonstrated subarachnoid hemorrhage (SAH). A right C-5 hemilaminectomy was performed. This case is unique in that there was no indication that the lumbar intrathecal catheter had fractured prior to the patient's presentation with SAH. This case demonstrates that intrathecal catheter fragments are mobile and can precipitate intracranial morbidity. Extrication of known fragments is safe and should be attempted to prevent further neurosurgical morbidity. |
| Databáze: | OpenAIRE |
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