title: Delayed Onset of Subdural Hematoma following Epidural Catheter Breakage.
abstract: Study Design Case report. Objectives To describe a case of delayed-onset spinal hematoma following the breakage of a spinal epidural catheter. Methods The authors describe the clinical case review. Results A 64-year-old woman had undergone epidural anesthesia 18 years before she was referred to our hospital because of lower-back pain and lower neurologic deficit with leg pain. The clinical examination showed the presence of a fragment of an epidural catheter in the thoracolumbar canal, as assessed by computed tomography, and a spinal hematoma that compressed the spinal cord at the same spinal level, as assessed by magnetic resonance imaging. Surgical removal of the epidural catheter and decompression surgery were performed. The patient exhibited substantial clinical improvement 1 month after surgery; she achieved a steady gait without the need for a cane and had no leg pain. Conclusion This is the first report of delayed onset of spinal hematoma following the breakage of an epidural catheter. Generally, when the breakage of an epidural catheter occurs without symptoms, follow-up alone is recommended. However, because spinal hematoma might exhibit a late onset, the possibility of this complication should be considered when deciding whether to remove the catheter fragment. We believe that in our patient, there could be a relationship between the catheter fragment and subdural hematoma, and catheter breakage could have been a risk factor for the spinal hematoma.
authors.affiliation: Department of Orthopedic Surgery, Nagoya University School of Medicine, Nagoya, Japan.
authors.forename: Yoshimoto
authors.initials: Y
authors.lastname: Ishikawa
authors.affiliation: Department of Orthopedic Surgery, Nagoya University School of Medicine, Nagoya, Japan.
authors.forename: Shiro
authors.initials: S
authors.lastname: Imagama
authors.affiliation: Department of Orthopedic Surgery, Nagoya University School of Medicine, Nagoya, Japan.
authors.forename: Zenya
authors.initials: Z
authors.lastname: Ito
authors.affiliation: Department of Orthopedic Surgery, Nagoya University School of Medicine, Nagoya, Japan.
authors.forename: Kei
authors.initials: K
authors.lastname: Ando
authors.affiliation: Department of Urology, Nagoya University School of Medicine, Nagoya, Japan.
authors.forename: Momokazu
authors.initials: M
authors.lastname: Gotoh
authors.affiliation: Department of Anesthesiology, Nagoya University School of Medicine, Nagoya, Japan.
authors.forename: Kimitoshi
authors.initials: K
authors.lastname: Nishiwaki
authors.affiliation: Department of Quality of Patient Safety, Nagoya University School of Medicine, Nagoya, Japan.
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Nagao
authors.affiliation: Department of Orthopedic Surgery, Nagoya University School of Medicine, Nagoya, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Ishiguro
keywords: breakage; complication; epidural catheter; spinal interdural hematoma
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