title: Intraspinal and intracranial hemorrhage after lumbar puncture.
abstract: Two cases of spinal epidural hematoma and two cases of intracranial subdural hematoma after lumbar puncture (LP) are reported in children receiving chemotherapy for acute lymphoblastic leukemia and non-Hodgkin lymphoma. The bleeding was asymptomatic but interfered with treatment in one case, and caused either severe backache or headache but no neurological deficit in the other three patients. The platelet counts were 8 and 46 x 10(9)/L in two patients and were normal in the other patients at the time of LP. All recovered without surgical treatment. There is an inherent, albeit uncommon, risk of bleeding into the central nervous system associated with LP in children with cancer and should be distinguished from postdural puncture headache (PDPH). Thrombocytopenia is not always an accompanying factor.
authors.affiliation: Department of Paediatrics and Adolescent Medicine, Tuen Mun Hospital, New Territories, Hong Kong, China. aclee@graduate.hku.hk
authors.forename: Anselm C W
authors.initials: AC
authors.lastname: Lee
authors.forename: Yu
authors.initials: Y
authors.lastname: Lau
authors.forename: C H
authors.initials: CH
authors.lastname: Li
authors.forename: Y C
authors.initials: YC
authors.lastname: Wong
authors.forename: Alan K S
authors.initials: AK
authors.lastname: Chiang
mesh_terms: D000293:Adolescent; D000970:Antineoplastic Agents / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D005260:Female; D046748:Hematoma, Epidural, Spinal / Q000209:etiology*; D046648:Hematoma, Subdural, Intracranial / Q000209:etiology*; D006801:Humans; D007278:Injections, Spinal / Q000009:adverse effects; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy; D008297:Male; D010976:Platelet Count; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy; D013129:Spinal Puncture / Q000009:adverse effects*
chemical_list: D000970:Antineoplastic Agents