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American Journal of Hospice and Palliative Medicine®
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Management of Pericatheter Cerebrospinal Fluid Leak After Intrathecal Implantation of a Drug Delivery System

Prem K. Singh, MD

Department of Anesthesia All India Institute of Medical Sciences

Roopesh Jain, MD

Department of Anesthesia All India Institute of Medical Sciences

Seema Mishra, MD

Department of Anesthesia All India Institute of Medical Sciences

Sunil Kumar, MS

Department of Surgical Oncology, All India Institute of Medical Sciences, New Delhi, India

Sushma Bhatnagar, MD

Department of Anesthesia All India Institute of Medical Sciences, shumob{at}yahoo.com

Suryanand Deo, MS

Department of Surgical Oncology, All India Institute of Medical Sciences, New Delhi, India

Persistent cerebrospinal fluid leak is a known complication of intrathecal pump system insertion for drug delivery. Various treatment modalities, such as an epidural blood patch, use of glue, removal of catheter, and surgical closure of dura and subdural blood patch, have been reported previously. This report presents a 35-year-old woman in whom an intrathecal pump system was inserted for cancer pain management with intrathecal morphine. This was complicated by a persistent cerebrospinal fluid leak that was successfully managed by purse-string sutures over the dura around the catheter, without removing the intrathecal implant. The cause of the cerebrospinal fluid leak and different treatment approaches are discussed.

Key Words: intrathecal pump • cerebrospinal fluid leak • dura purse-string suture • morphine

American Journal of Hospice and Palliative Medicine®, Vol. 25, No. 3, 237-239 (2008)
DOI: 10.1177/1049909108315520
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