Severe intracranial and intraspinal subarachnoid hemorrhage after lumbar puncture: a rare case report

Liu, Wei Hsiu; Lin, Ji-Ping; Lin, Jerry W.; Hsin, I.

doi:10.1016/j.ajem.2007.10.008

Cited by 17 publications

(19 citation statements)

References 10 publications

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“…Our review of the literature, however, revealed 2 cases of spontaneous spinal SAH associated with cerebral SAH [25, 26]. One case was recently documented in the Spanish literature, and the other evolved from a complicated lumbar puncture.…”

Section: Discussionmentioning

confidence: 99%

Cerebral Vasospasm with Ischemia following a Spontaneous Spinal Subarachnoid Hemorrhage

Farhat

2013

Case Reports in Medicine

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Cerebral vasospasm is a well-known consequence of aneurysmal subarachnoid hemorrhage (SAH) triggered by blood breakdown products. Here, we present the first case of cerebral vasospasm with ischemia following a spontaneous spinal SAH. A 67-year-old woman, who was on Coumadin for atrial fibrillation, presented with chest pain radiating to the back accompanied by headache and leg paresthesias. The international normalized ratio (INR) was 4.5. Ten hours after presentation, she developed loss of movement in both legs and lack of sensation below the umbilicus. Spine MRI showed intradural hemorrhage. Her coagulopathy was reversed, and she underwent T2 to T12 laminectomies. A large subarachnoid hematoma was evacuated. Given her complaint of headache preoperatively and the intraoperative finding of spinal SAH, a head CT was done postoperatively that displayed SAH in peripheral sulci. On postoperative day 5, she became obtunded. Brain MRI demonstrated focal restricted diffusion in the left frontoparietal area. Formal angiography revealed vasospasm in anterior cerebral arteries bilaterally and right middle cerebral artery. Vasospasm was treated, and she returned to baseline within 48 hours. Spontaneous spinal SAH can result in the same sequelae typically associated with aneurysmal SAH, and the clinician must have a degree of suspicion in such patients. The pathophysiological mechanisms underlying cerebral vasospasm may explain this unique case.

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Section: Discussionmentioning

confidence: 99%

Cerebral Vasospasm with Ischemia following a Spontaneous Spinal Subarachnoid Hemorrhage

Farhat

2013

Case Reports in Medicine

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“…9 Although lumbar puncture is usually a safe routine procedure, rarely serious complications such as subarchnoid haemorrhage, spinal epidural haematoma and intraventricular haemorrhage can occur. 10,11 There is only one previous case-report on subarachnoid haemorrhage in a patient with ITB pump. 12 In this case, a broken fragment of the intrathecal catheter migrated into the prepontine cistern and caused venous bleeding.…”

Section: Discussionmentioning

confidence: 99%

Subarachnoid haemorrhage: an unusual complication of implantation of an intrathecal baclofen pump

Broadhurst

Thumbikat

Romanowski

et al. 2015

Spinal Cord Ser Cases

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“…The most likely mechanism is that needling traumatized the fine radicular vessels parallel to nerve roots6,14). In general, the natural flow of CSF tends to dilute and wash away blood.…”

Section: Discussionmentioning

confidence: 99%

Spinal Subarachnoid Hematoma as a Complication of an Intramuscular Stimulation : Case Report and a Review of Literatures

Lee

Chung

2013

J Korean Neurosurg Soc

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Intramuscular stimulation (IMS) is widely used to treat myofascial pain syndrome. IMS is a safe procedure but several complications have been described. To our knowledge, spinal subarachnoid hematoma has never been reported as a complication of an IMS. The authors have experienced a case of spinal subarachnoid hematoma occurring after an IMS, which was tentatively diagnosed as intracranial subarachnoid hemorrhage because of severe headache. Patient was successfully treated with surgery. Here, we report our case with a review of literature.

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Severe intracranial and intraspinal subarachnoid hemorrhage after lumbar puncture: a rare case report

Cited by 17 publications

References 10 publications

Cerebral Vasospasm with Ischemia following a Spontaneous Spinal Subarachnoid Hemorrhage

Cerebral Vasospasm with Ischemia following a Spontaneous Spinal Subarachnoid Hemorrhage

Subarachnoid haemorrhage: an unusual complication of implantation of an intrathecal baclofen pump

Spinal Subarachnoid Hematoma as a Complication of an Intramuscular Stimulation : Case Report and a Review of Literatures

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