title: [Spinal cord hemorrhage complicating diagnostic lumbar puncture].
abstract: BACKGROUND
  Spinal cord hematoma is a serious and feared complication of lumbar puncture. We here describe two patients who developed a spinal cord hematoma following diagnostic lumbar punctures.
  
  
  METHODS
  CASE 1: a 22-year-old male with a syndrome of cerebrospinal fluid hypotension, with normal coagulation parameters, underwent a traumatic, diagnostic lumbar puncture followed, a few hours later, by back pain irradiated to the legs. MRI showed the presence of a subdural hematoma from the lower dorsal region to the sacral region. A conservative approach, without surgery, was decided and he showed a complete recovery. CASE 2: a 69-year-old woman underwent a diagnostic lumbar puncture for the study of recent-onset headache with tinnitus and unstable gait. Puncture was traumatic and cerebrospinal fluid was normal. A few hours later, she complained of back pain and sciatica, and examination revealed a bilateral Lassegue sign. She required urinary catheterization. MRI showed an epidural hematoma from the T10 vertebra to the sacral area. Her outcome with a conservative approach was also excellent.
  
  
  CONCLUSIONS
  Spinal cord hematomas can occur after a traumatic lumbar puncture in people without coagulation disorders or any other predisposing factor. Although surgery has been traditionally advocated in these cases, a conservative approach is an option when symptoms are mild and a close follow-up is possible.
authors.affiliation: Servicio de Neurología, Unidad de Galdakao, Hospital de Galdakao-Usansolo, Galdakao, Vizcaya, España. joseluis.sanchezmenoyo@osakidetza.net
authors.forename: J L
authors.initials: JL
authors.lastname: Sánchez-Menoyo
authors.forename: J
authors.initials: J
authors.lastname: Ruiz-Ojeda
authors.forename: A
authors.initials: A
authors.lastname: Martínez-Arroyo
authors.forename: J C
authors.initials: JC
authors.lastname: García-Moncó
authors.forename: M
authors.initials: M
authors.lastname: Aduna-De Paz
authors.forename: I
authors.initials: I
authors.lastname: Vicente-Olabarría