title: Cerebellar coning and uncal herniation in childhood acute leukaemia.
abstract: 188 cases of childhood leukaemia came to necropsy at Children's Hospital of Los Angeles between 1965 and 1978. The necropsy records show that cerebellar coning and/or uncal herniation occurred in 5 of 47 cases with central nervous system (CNS) leukaemia and in only 1 of 141 without meningeal or cerebral infiltration. A review of the 168 cases of acute lymphocytic leukaemia treated at the University Hospital, Kuala Lumpur, since 1968 revealed another instance of coning, which occurred in a patient with CNS leukaemia. 4 of these 7 children with coning and/or uncal herniation did not have papilloedema, and the diagnosis was made only at necropsy. Coning was recognized 48 h after lumbar puncture in 2 children. In the other 5 cases, there was no relation between coning and lumbar puncture. This life-threatening complication should be considered before patients with CNS leukaemia are subjected to lumbar puncture.
mesh_terms: D000367:Age Factors; D000970:Antineoplastic Agents / Q000008:administration & dosage; D002526:Cerebellar Diseases / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007278:Injections, Spinal; D007427:Intracranial Pressure; D007945:Leukemia, Lymphoid / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D008297:Male; D008577:Meningeal Neoplasms / Q000150:complications*; D013129:Spinal Puncture / Q000009:adverse effects
chemical_list: D000970:Antineoplastic Agents