Hematomyelia Secondary to Lumbar Cerebrospinal Fluid Acquisition in a Dog

Abstract

A 2-year-old male (Hungarian Vizsla) was evaluated for progressive discomfort of possible spinal origin. A minimum data base, thoracolumbar magnetic resonance (MR) imaging examination and electrophysiologic investigation were all normal. Cerebellomedullary and lumbar cerebrospinal fluid (CSF) was collected. The fluid was unremarkable except for elevated total protein. Shortly, thereafter, the dog had progressive neurologic deterioration referable to a caudal lumbar spinal cord lesion. In a repeated MR examination there was a well-circumscribed intramedullary lesion at the site where lumbar CSF was collected. The signal characteristics of the lesion were compatible with subacute hemorrhage, which was confirmed to be hematomyelia at the time of successful decompressive surgery.

Spontaneous thoracolumbar hematomyelia secondary to hemophilia B in a cat

“…6–8 Other reported underlying causes of spontaneous intraspinal hemorrhage in dogs include Angiostrongylus vasorum and Leishmania infantum infection, juvenile polyarteritis syndrome, Von Willebrand factor deficiency, vascular malformations, iatrogenic secondary to cerebrospinal fluid collection, brown snake envenomation, intervertebral disc herniation, trauma and neoplasia. 9–15 …”

Intra-parenchymal brainstem haemorrhage secondary to iatrogenic needle injury after a parenteral injection in a cat

“…CNS iatrogenic needle injuries have previously been reported following CSF collection attempts from the CMC and caudal lumbar site in dogs, and following microchip implantation in dogs and cats. 5–8 A self-inflicted needle-stick injury and spinal cord infarction has been described in a human being. 9 In the present case, we suspect that the needle entered the CNS through the atlanto-occipital junction.…”

“…However, the acute onset after the neck parenteral injection attempt, the skin lesion, the orientation of the suspected muscle needle tract and the similar imaging findings to the previously described iatrogenic traumatic brainstem and lumbar needle injuries in dogs strongly support our presumptive diagnosis. 5,6 …”

Migrating sewing needle in the cervical vertebral canal in a dog

“…It was observed that haemorrhage was present in the more severe cases. Another case was reported to have suffered neurological deterioration after lumbar CSF tap (Platt and others 2005). Similarly, intramedullary haemorrhage was observed in this case on MRI four days after the lumbar spinal tap.…”

“…Similarly, intramedullary haemorrhage was observed in this case on MRI four days after the lumbar spinal tap. In all these cases, it was suspected that intramedullary haemorrhage secondary to injury with the needle was the main factor for the deterioration of the neurological signs (Platt and others 2005, Luján and others 2008). In the case presented here, it is suspected that the needle did not interrupt the spinal cord vasculature, thereby avoiding major neurological deficits associated with excessive haemorrhage.…”