Subdural catheter migration may lead to baclofen pump dysfunction.
- Pasquier Y Spinal Cord Unit, Clinic of Reeducation, Department of Clinical Neuroscience, University Hospital of Geneva, Switzerland.
- Cahana A
- Schnider A
- 2003-11-26
Published in:
- Spinal cord. - 2003
Accidental Falls
Adult
Baclofen
Catheterization
Equipment Failure
Follow-Up Studies
Foreign-Body Migration
Humans
Infusion Pumps, Implantable
Male
Muscle Relaxants, Central
Muscle Spasticity
Paraplegia
Rehabilitation Centers
Reoperation
Risk Assessment
Spinal Cord Injuries
Substance Withdrawal Syndrome
Thoracic Vertebrae
Tomography, X-Ray Computed
Treatment Outcome
English
OBJECTIVES
To report an unusual cause of intrathecal drug delivery failure in baclofen pump device.
STUDY DESIGN
A case report of an SCI patient treated with intrathecal baclofen, presenting a drug withdrawal.
SETTING
Regional spinal cord injuries centre in Geneva (Switzerland).
METHODS
We present a case of a 38-year-old male with complete T9 spastic paraplegia for 15 years, treated with intrathecal baclofen for 11 years. He recently presented to our centre with a spastic hypertonic episode, associated with rhabdomyolysis.
RESULTS
Standard investigations were unrevealing. However, a CT scan performed after injecting a radio-opaque solution by the side port of the pump, showed an unexpected catheter migration into the subdural space. Surgical revision reversed withdrawal symptoms.
CONCLUSIONS
Subdural catheter migration must be considered in the differential diagnosis of intrathecal drug delivery system failures. We recommend the use of the CT scan after contrast injection, to detect the localization of the distal catheter tip and confirm the normal diffusion into the subarachnoid space.
To report an unusual cause of intrathecal drug delivery failure in baclofen pump device.
STUDY DESIGN
A case report of an SCI patient treated with intrathecal baclofen, presenting a drug withdrawal.
SETTING
Regional spinal cord injuries centre in Geneva (Switzerland).
METHODS
We present a case of a 38-year-old male with complete T9 spastic paraplegia for 15 years, treated with intrathecal baclofen for 11 years. He recently presented to our centre with a spastic hypertonic episode, associated with rhabdomyolysis.
RESULTS
Standard investigations were unrevealing. However, a CT scan performed after injecting a radio-opaque solution by the side port of the pump, showed an unexpected catheter migration into the subdural space. Surgical revision reversed withdrawal symptoms.
CONCLUSIONS
Subdural catheter migration must be considered in the differential diagnosis of intrathecal drug delivery system failures. We recommend the use of the CT scan after contrast injection, to detect the localization of the distal catheter tip and confirm the normal diffusion into the subarachnoid space.
- Language
-
- English
- Open access status
- bronze
- Identifiers
-
- DOI 10.1038/sj.sc.3101536
- PMID 14639451
- Persistent URL
- https://folia.unifr.ch/global/documents/200635
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