Symptomatic Spinal Epidural Collections after Lumbar Puncture in Children

Koch, Bernadette L.; Moosbrugger, E.A.; Egelhoff, John C.

doi:10.3174/ajnr.a0634

Cited by 42 publications

(27 citation statements)

References 11 publications

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“…12 Strupp et al 13 demonstrated that stylet reinsertion before spinal needle removal significantly reduced the occurrence of post-lumbar puncture symptoms. In 1 retrospective study, the number of lumbar puncture attempts did not correlate with the size of the epidural CSF collection, 14 which was true in our patient. Finally, although our patient remained supine for 3 hours postprocedure, recumbent positioning has not been proven to reduce post-lumbar puncture symptoms.…”

Section: Discussionmentioning

confidence: 45%

“…15 Evaluation of the symptomatic patient after a lumbar puncture should begin with a thorough neurologic examination. Magnetic resonance imaging can delineate the size and signal intensity of the collection, 14 although it may be difficult to radiographically differentiate CSF, blood, and pus. Our patient presented with fever, which raised suspicion of an epidural abscess and necessitated laminectomy by neurosurgery for definitive diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…However, in the well-appearing child with no concern for hematoma or infection, these CSF collections can often be managed nonoperatively without any neurologic sequelae. 6,14 Although recumbency has not proven beneficial to prevent CSF collections, lying supine can provide symptomatic relief. 6 Patients may require admission for pain control or if the diagnosis is uncertain.…”

Section: Discussionmentioning

confidence: 99%

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Epidural Cerebrospinal Fluid Collection After Lumbar Puncture

Aronson¹,

Zonfrillo²

2009

Pediatric Emergency Care

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Lumbar puncture is a common procedure in the emergency department. Cerebrospinal fluid (CSF) leak through a dural tear can cause transient side effects including headache and backache, although more severe symptoms may occur. These CSF collections can be managed nonoperatively without any neurologic sequelae. We report a patient with a symptomatic epidural CSF collection after diagnostic lumbar puncture, followed by a brief review of the literature including discussion of techniques that can reduce CSF leak.

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Section: Discussionmentioning

confidence: 45%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Epidural Cerebrospinal Fluid Collection After Lumbar Puncture

Aronson¹,

Zonfrillo²

2009

Pediatric Emergency Care

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“…Koch et al . [3] found that MR studies in 25 pediatric patients (average age 5 years, 1 month old) undergoing LPs had epidural CSF collections on MR scans; symptoms also fully resolved with conservative treatment. When Amini et al .…”

Section: Discussionmentioning

confidence: 99%

Epidural cerebrospinal fluid collection following lumbar puncture in an adult patient: A case report and literature review

Cavaleri¹,

Perez²,

Ozpinar³

et al. 2018

Surg Neurol Int

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Background:Cerebrospinal fluid (CSF) leakage into the epidural space following lumbar puncture (LP) has been documented in pediatric patients, but there have been no reported cases in adults.Case Description:We report an epidural CSF leak in an adult who presented with back pain, positional headache, urinary retention, and constipation following an LP performed as a part of a research study. The patient's magnetic resonance (MR) scan showed an extensive epidural CSF collection. Following placement in a recumbent position for 72 h, the collection fully resolved along with his neurological complaints.Conclusion:Symptomatic epidural CSF collections rarely occur in adults following LPs. Nevertheless, the management remains the same as for pediatric patients; bed rest for 72 h results typically in full resolution of symptoms/signs and regression of the collection on MR studies.

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“…Infection and shunt dysfunction are very rare consequences of the implantation. However, epidural, subdural, subarachnoid and intracerebral hemorrhages have been cited as rare complications of lumbar punctures [3]. Cerebrospinal fluid fistulas primarily occur in children [4].…”

Section: Introductionmentioning

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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Symptomatic Spinal Epidural Collections after Lumbar Puncture in Children

Cited by 42 publications

References 11 publications

Epidural Cerebrospinal Fluid Collection After Lumbar Puncture

Epidural Cerebrospinal Fluid Collection After Lumbar Puncture

Epidural cerebrospinal fluid collection following lumbar puncture in an adult patient: A case report and literature review

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

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