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

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.