Acute hemorrhagic complication of diagnostic lumbar puncture

Mark D. Adler, Anne Marie Spalding Comi, Allen R. Walker

Research output: Contribution to journalArticle

Abstract

Objective: To present a case of an epidural hematoma after lumbar puncture in a pediatric patient without known risk factors for such a complication and to review the literature regarding this complication. Design: Case report, review of the literature, and discussion. Data Sources: A review of MEDLINE (1966-1998) for keywords "lumbar puncture" and "hemorrhage" or "hematoma" was conducted, and each bibliography was reviewed for other sources extending to 1911. Articles describing a case of spinal hematoma after a lumbar puncture for any procedure were included. Results: A 5-year-old boy underwent a lumbar puncture for evaluation of lethargy and fever, and subsequently developed marked back pain and severe pain on flexion of his legs. Magnetic resonance imaging revealed an epidural blood collection. The patient's symptoms resolved over the next few days in association with steroid administration. Multiple reports of epidural and subdural hematomas were found on literature review, most occurring in the setting of coagulation abnormalities. These reports involve lumbar puncture in anesthetic, interventional, and diagnostic settings. Conclusion: Lumbar puncture is a frequently employed procedure. Known complications include epidural, subdural, and subarachnoid hemorrhage, usually in the setting of abnormal coagulation. The case presented is unusual in that the patient is a child and lacks any known risk factors for a hemorrhagic complication. Such a complication appears to be rare; only five of the 64 cases discovered in the literature review occurred following this diagnostic procedure in patients without known risk factors.

Original languageEnglish (US)
Pages (from-to)184-188
Number of pages5
JournalPediatric Emergency Care
Volume17
Issue number3
DOIs
StatePublished - 2001

Fingerprint

Spinal Puncture
Hematoma
Subdural Hematoma
Lethargy
Information Storage and Retrieval
Bibliography
Subarachnoid Hemorrhage
Back Pain
MEDLINE
Anesthetics
Leg
Fever
Steroids
Magnetic Resonance Imaging
Pediatrics
Hemorrhage
Pain

Keywords

  • Epidural hemorrhage
  • Hemorrhage
  • Lumbar puncture

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Nursing(all)
  • Emergency Medicine

Cite this

Acute hemorrhagic complication of diagnostic lumbar puncture. / Adler, Mark D.; Comi, Anne Marie Spalding; Walker, Allen R.

In: Pediatric Emergency Care, Vol. 17, No. 3, 2001, p. 184-188.

Research output: Contribution to journalArticle

Adler, Mark D. ; Comi, Anne Marie Spalding ; Walker, Allen R. / Acute hemorrhagic complication of diagnostic lumbar puncture. In: Pediatric Emergency Care. 2001 ; Vol. 17, No. 3. pp. 184-188.
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