# Retained Lumbar Drain Tip Leading to Intrathecal Hematoma: A Case Report on Perioperative Risks and Management

## TL;DR

A 79-year-old woman died after complications from a retained lumbar drain tip and intrathecal hematoma during aortic aneurysm surgery.

## Contribution

This case report highlights the risks of catheter retention and hematoma in spinal cord protection during aortic surgery.

## Key findings

- A retained lumbar drain tip led to intrathecal hematoma in a patient on anticoagulation.
- Postoperative neurological deterioration occurred despite initial improvement with the lumbar drain.
- The case resulted in death, emphasizing the need for careful catheter management and monitoring.

## Abstract

Intrathecal catheters, commonly used for cerebrospinal fluid (CSF) drainage during thoracoabdominal aortic aneurysm (TAAA) repair, play a critical role in protecting the spinal cord and reducing the risk of paraplegia. However, their use is associated with significant complications, including infection, catheter retention, and hematoma formation, particularly in anticoagulated patients. We present the case of a 79-year-old woman who developed an intrathecal hematoma following lumbar drain removal, complicated by a retained catheter tip and perioperative anticoagulation therapy. Despite initial neurological improvement after lumbar drain placement, her condition deteriorated postoperatively, resulting in progressive neurological deficits and, ultimately, death. This case highlights the importance of meticulous technique in lumbar drain management, careful anticoagulation monitoring, and heightened vigilance for complications requiring prompt recognition and intervention.