Spinal subdural hematoma in a leukemic child

Wolcott, George J.; Grunnet, Margaret L.; Lahey, M. Eugene

doi:10.1016/s0022-3476(70)80095-6

Cited by 31 publications

(6 citation statements)

References 4 publications

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“…After excluding reports of LP in the presence of anticoagulants, 11 reports were found that described 18 LPs in thrombocytopenic patients (platelet count 1–63 × 10 9 /l), complicated by spinal haematomas (Scott et al , 1989; Ayerbe et al , 2005; Edelson et al , 1974; Lee et al , 2007; Mapstone et al , 1983; Pai et al , 2002; Wirtz et al , 2000; Wolcott et al , 1970; Blade et al , 1983; Dunn et al , 1979; Masdeu et al , 1979). An additional three patients without thrombocytopenia that had spinal haematomas were also described in these reports (Lee et al , 2007; Masdeu et al , 1979).…”

Section: Case Reports Of Lpmentioning

confidence: 99%

The risk of spinal haematoma following neuraxial anaesthesia or lumbar puncture in thrombocytopenic individuals

2009

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Summary Neuraxial anaesthesia is increasingly performed in thrombocytopenic patients at the time of delivery of pregnancy. There is a lack of data regarding the optimum platelet count at which spinal procedures can be safely performed. Reports are often confounded by the presence of other risk factors for spinal haematomata, such as anticoagulants, antiplatelet agents and other acquired or congenital coagulopathies/platelet function defects or rapidly falling platelet counts. In the absence of these additional risk factors, a platelet count of 80 × 109/l is a ‘safe’ count for placing an epidural or spinal anaesthetic and 40 × 109/l is a ‘safe’ count for lumbar puncture. It is likely that lower platelet counts may also be safe but there is insufficient published evidence to make recommendations for lower levels at this stage. For patients with platelet counts of 50–80 × 109/l requiring epidural or spinal anaesthesia and patients with a platelet count 20–40 × 109/l requiring a lumbar puncture, an individual decision based on assessment of risks and benefits should be made.

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Section: Case Reports Of Lpmentioning

confidence: 99%

The risk of spinal haematoma following neuraxial anaesthesia or lumbar puncture in thrombocytopenic individuals

2009

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“…However, in their case, the patient had a congenital fibrinogen deficiency. Intraspinal hematoma can occur in patients with coagulopathy [5], in anticoagulant or thrombolytic drug users [5,6] and in children with leukemia [12]. In some cases, even spontaneous intradural bleeding is noted [5,6].…”

Section: Discussionmentioning

confidence: 99%

Spinal Intradural Hematoma and Permanent Paraparesis after a Lumboperitoneal Shunt Operation: An Unusual Complication

et al. 2014

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Pseudotumor cerebri is a condition of increased intracranial pressure in the absence of clinical, laboratory or radiological pathology. Spinal intradural hematoma formation after lumboperitoneal shunt (LPS) implantation is very rare, but it can cause sudden and serious deterioration. In this report, we present a patient who developed an intradural hematoma following LPS operation. A 27-year-old male patient suffering from headaches and progressive vision loss was diagnosed with pseudotumor cerebri. He underwent LPS operation in January 2009. Four hours after the operation, he developed urinary and fecal incontinence with paraparesis (1/5). Lumbar magnetic resonance imaging identified an intradural hematoma at the level of L2-L3, and he was reoperated. The intradural hematoma was removed. Physical therapy was started because of paraparesis. Two months later, the patient's muscle strength had increased to 3/5. Surgeons must remember that, LPS implantation can cause a spinal intradural hematoma in a small percentage of patients, with catastrophic results.

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“…Three of these 10 patients were treated with laminectomy to remove the hematoma, 6 hematomas were confirmed by laminectomy at autopsy, and 1 patient had no surgical treatment and mild sequelae. 1,10,11 Last, 6 spontaneous epidural hematomas have been reported in children with no known bleeding dyscrasias; these patients were also treated with laminectomy. 7 We report 25 children with post-LP spinal EDC who did not have typical imaging characteristics of hemorrhage and whose EDC was thought to be primarily related to CSF leak- age.…”

Section: Discussionmentioning

confidence: 99%