Cerebral venous thrombosis as a complication of intracranial hypotension after lumbar puncture

Abstract

BackgroundOptic neuritis is recognised by the international classification of headache disorders as a painful cranial nerve lesion. A lumbar puncture may be performed in the investigation of optic neuritis. Postdural puncture headache (PDPH) due to intracranial hypotension is a frequent complication of this procedure. In contrast, cerebral venous thrombosis (CVT) is a rare but potentially fatal complication of dural puncture. A few studies have identified an association between iron deficiency anaemia and venous thrombosis. There are no reports linking CVT with lumbar puncture and iron deficiency anaemia.Methods and resultsWe present a 32-year-old woman with optic neuritis and iron deficiency anaemia complicated by a PDPH and CVT.ConclusionCVT should be considered in a patient with persistent headache, recent lumbar puncture and iron deficiency anaemia. Early recognition and treatment of this condition are vital to avoiding mortality and morbidity.

Pediatric post‐dural puncture headache and paraplegia

“…This is an unusual complication of a spinal CSF leak that has been known since the 1980s. [10][11][12][13][14] To our knowledge, this has not been reported previously in children following a lumbar puncture. Intracranial hypotension may result in cerebral venous thrombosis by one or more of several mechanisms.…”

“…Cortical vein thrombosis was diagnosed in our second patient following her lumbar puncture. This is an unusual complication of a spinal CSF leak that has been known since the 1980s 10–14 . To our knowledge, this has not been reported previously in children following a lumbar puncture.…”

“…Intracranial hypotension may result in cerebral venous thrombosis by one or more of several mechanisms. [10][11][12][13][14] First, as dictated by the Monro-Kellie doctrine, intracranial hypotension is associated with venous engorgement due to the loss of result in spinal cord displacement due to loss of intrathecal CSF, paraplegia from spinal cord compression has not been reported in this setting. Bibrachial amyotrophy is characterized by painless weakness and atrophy of the shoulder and upper extremity musculature.…”

“…To our knowledge, this has not been reported previously in children following a lumbar puncture. Intracranial hypotension may result in cerebral venous thrombosis by one or more of several mechanisms 10–14 . First, as dictated by the Monro–Kellie doctrine, intracranial hypotension is associated with venous engorgement due to the loss of CSF.…”