Subarachnoid fat dissemination secondary to intrathecal pump

J Clin Neurosci. 2020 Aug:78:416-417. doi: 10.1016/j.jocn.2020.04.120. Epub 2020 Apr 30.

Abstract

Implantable intrathecal infusion pumps (ITPs) are an effective pain management modality for patients who have failed non-operative options. We present the first report of asymptomatic intracranial subarachnoid fat dissemination secondary to an ITP. A 39-year-old who underwent implantation of an ITP for intractable pelvic pain developed altered mental status. CT and MRI revealed subarachnoid fat deposition without evidence of a dermoid or epidermoid cyst. She returned to her baseline mental status with her symptoms attributed to delirium. The rare possibility of subarachnoid fat dissemination following transdural spinal procedures should be considered as a potential complication of ITPs. Although fat may persist in the subarachnoid space for years, asymptomatic patients can be safely managed with observation alone.

Keywords: Complication; Fat; Intracranial; Intrathecal pump; Pain management; Subarachnoid.

Publication types

  • Case Reports

MeSH terms

  • Adipose Tissue / diagnostic imaging
  • Adipose Tissue / growth & development*
  • Adipose Tissue / pathology
  • Adult
  • Epidermal Cyst
  • Female
  • Humans
  • Infusion Pumps, Implantable / adverse effects*
  • Injections, Spinal / adverse effects
  • Magnetic Resonance Imaging
  • Pain Management
  • Pain, Intractable / therapy
  • Subarachnoid Space / diagnostic imaging
  • Subarachnoid Space / pathology*