Paraplegia following lumbar puncture: a rare complication in spinal dural arteriovenous fistula

Çakar, Arman; Akçay, Halil İbrahim; Gündüz, Tuncay; Kürtüncü, Murat

doi:10.1007/s13760-018-0951-7

Cited by 4 publications

(3 citation statements)

References 4 publications

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“…Severe neurological complications have been reported as case reports. 26,27 On the other hand, it has been reported that LP refusal is significantly associated with the use of broad-spectrum antibiotics, prolonged hospital stays, and poor patient outcomes. 28 Therefore, parents should be made aware of the potential complications of the LP procedure as well as the more significant consequence that LP refusal can present.…”

Section: Discussionmentioning

confidence: 99%

“…Complications after LP, such as local pain, skin infection, headaches, and lumbosacral spinal nerve injury, are mild and resolve spontaneously. Severe neurological complications have been reported as case reports 26,27 . On the other hand, it has been reported that LP refusal is significantly associated with the use of broad-spectrum antibiotics, prolonged hospital stays, and poor patient outcomes 28 .…”

Section: Discussionmentioning

confidence: 99%

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Parental Attitudes About Lumbar Puncture in Children With Suspected Central Nervous System Infection

Şahin¹,

Kara‐Aksay²,

Demir

et al. 2023

Pediatr Emer Care

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Objectives This study aimed to evaluate parents' attitudes toward lumbar puncture (LP) for their children with suspected central nervous system infection to determine the reasons for rejection and related factors. Methods The survey was provided to parents of children (1 month to 18 years old) for whom LP was recommended because of a concern for central nervous system infection. Sociodemographic characteristics and other related factors of parents who did and did not approve of LP were compared statistically. The reasons for the disapproval of parents who refused LP were revealed. Results A total of 100 parents were included in the study. Eighty-two percent of the participating parents were mothers, and the median age of the mothers was 31 years (min: 17 years; max: 70 years). The median age of the fathers was 37 years (min: 22 years; max: 60 years). Among the parents, 34% did not give consent for LP. The most common reason for the participants to refuse LP was fear of paralysis of their children due to the procedure (82.3%). There was a statistical difference between the approval of the LP procedure and the person who informed the parents about the LP procedure and read the informed consent form (P = 0.004 and P = 0.038, respectively). As a result of the binary logistic regression analysis, it was seen that the rate of acceptance of the LP procedure by the parents informed by the specialist doctors was 7.1-fold (P = 0.02; 95% confidence interval, 1.3–37.6) higher than the parents informed by the resident physicians. Conclusion The informed consent process mainly influenced parents' attitudes toward LP. To increase the acceptance rates of LP, we should standardize the informed consent process so that it is not affected by factors such as seniority of the physician.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Parental Attitudes About Lumbar Puncture in Children With Suspected Central Nervous System Infection

Şahin¹,

Kara‐Aksay²,

Demir

et al. 2023

Pediatr Emer Care

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“…The most common cause of pressure gradient change is an increase in intrathecal pressure. Therefore, it has been reported that the symptoms worsened in patients with SDAVF in the prone position for a long time during spinal surgery (16,17), or after singing or standing for a long time (18,19). Electroacupuncture is a method of applying electrical stimulation with about 20 needles inserted in the prone position for about 20-30 min (20), and it is highly likely that the increase in intrathecal pressure caused by the prone position for a long time made the condition worse.…”

Section: Discussionmentioning

confidence: 99%

Rapid Progression to Complete Paraplegia After Electroacupuncture in a Patient With Spinal Dural Arteriovenous Fistula: A Case Report

et al. 2021

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Spinal dural arteriovenous fistula (SDAVF) usually has an insidious clinical course, but 5–15% of the cases have acute exacerbations. In some cases, there is an abrupt progression to paraplegia following an epidural injection or anesthesia. Electroacupuncture is a form of acupuncture that applies a small electrical current to needles inserted at specific points in the body. It is widely used for its analgesic effect on back pain. In this study, we report a rare case of SDAVF in which the symptoms of a patient worsened rapidly to complete paraplegia within a few hours after applying electroacupuncture to his back. A 49-year-old man had rapid progression to complete paraplegia within a few hours of electroacupuncture on his back. MRI showed SDAVF and worsening of cord signal change. An emergency operation was performed to ligate the SDAVF. The patient was able to walk 1 month post-operatively. Most of the neurological deficits had disappeared by 1 year post-operatively, with normalization of MRI. Our case emphasizes that SDAVF patients should be careful when exposed to any circumstances that might affect the circulation around the dural arteriovenous fistula, such as electroacupuncture. Patients should also be warned in advance about the possibility of rapid exacerbation of neurological symptoms. Regardless of the severity of the neurological symptoms, immediate treatment is essential for recovery and a better outcome.

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Acute paraplegia in patient with spinal dural arteriovenous fistula after lumbar puncture and steroid administration: A case report

Alhendawy

Homapour

Chandra

et al. 2021

International Journal of Surgery Case Reports

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Highlights Spinal dural arteriovenous fistula is an uncommon cause of longitudinal transverse myelitis. Spinal dural arteriovenous fistula can be easily misdiagnosed. It usually presents with venous congestive myelopathy symptoms and misdiagnosis is common. Prescence of flow voids on MRI should raise the suspicion of underlying fistula. Intravenous steroid and lumbar puncture may be associated with acute neurological deterioration.

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Paraplegia following lumbar puncture: a rare complication in spinal dural arteriovenous fistula

Cited by 4 publications

References 4 publications

Parental Attitudes About Lumbar Puncture in Children With Suspected Central Nervous System Infection

Parental Attitudes About Lumbar Puncture in Children With Suspected Central Nervous System Infection

Rapid Progression to Complete Paraplegia After Electroacupuncture in a Patient With Spinal Dural Arteriovenous Fistula: A Case Report

Acute paraplegia in patient with spinal dural arteriovenous fistula after lumbar puncture and steroid administration: A case report

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