[Acute Subdural Hematoma due to the Breakage of an Epidural Catheter Left for a Long Time].

Abstract

Breakage of an epidural catheter occurs rarely dur- ing the insertion or removal procedures. In previous reports, the broken epidural catheter fragment need not be removed in asymptomatic patients. However, late-onset neurological symptoms might occur. This is a case of delayed onset subdural hematoma due to a broken epidural catheter retained in the body for 18 years. We considered that the catheter fragment might induce chronic inflammation and vascular fragil- ity around the catheter. Antiplatelet therapy might lead to the hematoma because this patient took an aspirin (antiplatelet drug) for over 9 years. Antiplatelet and anticoagulant therapies are likely to be a risk of hematoma. Thus, even without neurological symptoms, it is necessary to consider the removal of the epidural catheter fragment in patients on anti- platelet and anticoagulant therapy.