Anesthesiology ; methods ; Catheterization ; Equipment Failure ; Humans ; Infusions, Intravenous ; instrumentation ; Injections, Spinal ; instrumentation ; Needles ; Plastics

The intrathecal drug delivery system (ITDDS), an effective treatment tool for intractable spasticity and pain, is associated with various complications but breakage of the catheter is rare. We report the case of a 50-yr-old man with ITDDS, in whom an intrathecal catheter was severed, resulting in a 28.6-cm-long intrathecal fragment. The catheter completely retracted into the intrathecal space from the anchor site. The catheter was severed during spine flexion, and the total distal fragment was repositioned in the intrathecal space. Although the outcome of ITDDS was associated with the length or diameter of the broken catheter, no neurologic complications occurred in our patient. Thus, we inserted another catheter instead of removing the old one. Thereafter, the patient has been regularly followed up, and no neurologic complications have developed during the 28 months.
Brachial Plexus/injuries ; Catheters ; Drug Delivery Systems ; *Equipment Failure ; Fluoroscopy ; Humans ; Infusion Pumps, Implantable/*adverse effects ; Injections, Spinal/instrumentation ; Male ; Middle Aged ; Morphine/therapeutic use ; Pain/*drug therapy/etiology

Amphotericin B ; administration & dosage ; Antifungal Agents ; administration & dosage ; Child ; Cryptococcus neoformans ; drug effects ; pathogenicity ; Diagnosis, Differential ; Drug Delivery Systems ; instrumentation ; methods ; Humans ; Injections, Intraventricular ; Injections, Spinal ; Intracranial Hypertension ; complications ; drug therapy ; etiology ; Male ; Meningitis, Cryptococcal ; diagnosis ; drug therapy ; physiopathology ; Treatment Outcome