Spinal Subdural Hematomas Complicating Lumbar Puncture

Edelson, Richard N.

doi:10.1001/archneur.1974.00490380082011

Cited by 154 publications

(67 citation statements)

References 16 publications

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“…In spontaneous hematoma, traumas, infection, anticoagulation therapy, bleeding disorder, intradural tumor or arteriovenous malformation have been implicated as predisposing conditions (8,9). Iatrogenic injury has also been reported via lumbar puncture, epidural anesthesia or, rarely, direct injury at surgery (10)(11)(12).…”

Section: Discussionmentioning

confidence: 99%

Spinal subdural hematoma: a rare case of spinal subdural hematoma complicating routine, minimally invasive lumbar discectomy and decompression and relevant literature review

et al. 2017

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We present a case of apparently uncomplicated lumbar decompression and discectomy with delayed postoperative neurological deterioration secondary to subdural hematoma at the thoracolumbar level of the spinal cord. Previously described subdural hematomas have occurred spontaneously or related to iatrogenic Case Report Case presentationA 76-year-old presented with a 9-month history of radiating lower extremity pain, left worse than right, with minimal back pain. The symptoms onset acutely after lifting a heavy ice box. He reported intermittent paresthesias in bilateral L4−L5 distributions without any complaint of weakness. Symptoms worsened with extension, upright posture and Valsalva maneuver and improved with forward flexion. He had no prior spine surgery. He had 3 separate transforaminal epidural steroid injections containing anesthetic and cortisone directed at the left L3-4 and L4-5 space, the most recent of which was 1 month prior to presentation. With all injections he noted marked improvement during the anesthetic phase but no durable effect. His past medical history was significant for coronary artery disease status post remote stenting and peripheral arterial disease status post remote carotid endarterectomy. Aside from fish oil and daily low dose aspirin, he was not on anticoagulant medications.On exam, he had 5/5 motor strength in his bilateral lower extremities with no fixed, focal sensory deficits. His lower extremity reflexes were diffusely diminished though

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Section: Discussionmentioning

confidence: 99%

Spinal subdural hematoma: a rare case of spinal subdural hematoma complicating routine, minimally invasive lumbar discectomy and decompression and relevant literature review

et al. 2017

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“…One theory is that the SSH might originate in the subarachnoid space, dissect the arachnoid membrane, and spread into the subdural space. 3,12) The blood could be dissipated by the CSF faster in the subarachnoid space than in the subdural space. However, only one report has described bleeding from the subarachnoid space into the subdural space, namely from the radicular vein, as confirmed at the autopsy of a patient who had undergone lumbar puncture.…”

Section: Discussionmentioning

confidence: 99%

Lumbosacral Subdural Hematoma-Case Report-

Mashiko

Noguchi

Uemura³

et al. 2006

Neurol. Med. Chir.(Tokyo)

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An 18-year-old man presented with a rare spinal subdural hematoma (SSH) manifesting as headache, which developed following diving into the sea the day before. Computed tomography of the head revealed no abnormality. His headache persisted followed by neck stiffness and mild lumbago. He came to see us 6 days after the first visit. He underwent lumbar puncture to eliminate the possibility of meningitis. The cerebrospinal fluid showed xanthochromia. Cerebral angiography showed no abnormality. Magnetic resonance imaging of the spine revealed lumbosacral subdural hematoma. The hematoma and his symptoms regressed spontaneously during several weeks of conservative treatment. A sharp increase in intraabdominal and/or intrathoracic pressures following diving may have caused the bleeding. Headache may be an initial symptom associated with subarachnoid hemorrhage concomitant with SSH. Delayed progression of lumbosacral SSH must be considered if the patient complains of lumbago following minor trauma.

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“…In most cases, LP is difficult and yields bloody fluid. In these patients, platelet counts are low or falling, and platelet transfusion has not been provided before LP [7,47].…”

Section: Complicationsmentioning

confidence: 99%

Lumbar Puncture of the Newborn

Öncel¹

2018

Bedside Procedures

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Spinal Subdural Hematomas Complicating Lumbar Puncture

Cited by 154 publications

References 16 publications

Spinal subdural hematoma: a rare case of spinal subdural hematoma complicating routine, minimally invasive lumbar discectomy and decompression and relevant literature review

Spinal subdural hematoma: a rare case of spinal subdural hematoma complicating routine, minimally invasive lumbar discectomy and decompression and relevant literature review

Lumbosacral Subdural Hematoma-Case Report-

Lumbar Puncture of the Newborn

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