Migrating lumbar intrathecal catheter fragment associated with intracranial subarachnoid hemorrhage

Luke Hnenny, Hatem A. Sabry, Jeffrey S. Raskin, Jesse J. Liu, Neil E. Roundy, Aclan Dogan

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)47-51
Number of pages5
JournalJournal of neurosurgery. Spine
Volume22
Issue number1
DOIs
StatePublished - Jan 1 2015

Fingerprint

Subarachnoid Hemorrhage
Catheters
Failed Back Surgery Syndrome
Morbidity
Photophobia
Hypesthesia
Neck Pain
Morphine
Nausea
Headache
Leg
Head
Observation
Pharmaceutical Preparations

Keywords

  • intracranial morbidity
  • intrathecal morphine pump
  • lumbar spine
  • SAH = subarachnoid hemorrhage
  • subarachnoid hemorrhage
  • vascular disorders

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Migrating lumbar intrathecal catheter fragment associated with intracranial subarachnoid hemorrhage. / Hnenny, Luke; Sabry, Hatem A.; Raskin, Jeffrey S.; Liu, Jesse J.; Roundy, Neil E.; Dogan, Aclan.

In: Journal of neurosurgery. Spine, Vol. 22, No. 1, 01.01.2015, p. 47-51.

Research output: Contribution to journalArticle

Hnenny, Luke ; Sabry, Hatem A. ; Raskin, Jeffrey S. ; Liu, Jesse J. ; Roundy, Neil E. ; Dogan, Aclan. / Migrating lumbar intrathecal catheter fragment associated with intracranial subarachnoid hemorrhage. In: Journal of neurosurgery. Spine. 2015 ; Vol. 22, No. 1. pp. 47-51.
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