Anesth Pain Med.  2019 Apr;14(2):211-215. 10.17085/apm.2019.14.2.211.

Suspected transcutaneous cerebral spinal fluid leakage without postural headache after implantable intrathecal drug delivery system removal: A case report

• Yang J
• Choi Y
• Park J
• Jeong J
• Lee B
• Lee K
• Lee J
• Choi R

• KMID: 2447972
• DOI: http://doi.org/10.17085/apm.2019.14.2.211

Abstract

A 55-year-old man with an implantable intrathecal drug delivery system (IDDS) implant removal surgery was performed to control a suspected implant infection. Clear discharge from a lumbar wound was detected after IDDS removal, but transcutaneous cerebral spinal fluid (CSF) leakage was not suspected because the patient did not suffer from a postural headache. Finally, a suspected CSF leakage was resolved with a single epidural blood patch.

Keyword

Headache; Intrathecal drug delivery system; Post-dural-puncture-headache; Postherpetic neuralgia; Transcutaneous cerebral spinal fluid leakage

MeSH Terms

Blood Patch, Epidural
Drug Delivery Systems*
Headache*
Humans
Middle Aged
Neuralgia, Postherpetic
Wounds and Injuries

Figure

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  Fig. 1 Cervical anteriorposterior X-ray with cervical spinal cord stimulator.

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  Fig. 2 T–L junction anteriorposterior X-ray after morphine pump removal.

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  Fig. 3 Laboratory value trends after morphine pump removal. hsCRP: high-sensitivity C-reactive protein, POD: postoperative day.

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  Fig. 4 Dressing change frequency after morphine pump removal. POD: postoperative day.

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