[Spinal cord hemorrhage complicating diagnostic lumbar puncture].
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.
Sánchez-Menoyo
J L
JL
Servicio de Neurología, Unidad de Galdakao, Hospital de Galdakao-Usansolo, Galdakao, Vizcaya, España. joseluis.sanchezmenoyo@osakidetza.net
Ruiz-Ojeda
J
J
Martínez-Arroyo
A
A
García-Moncó
J C
JC
Aduna-De Paz
M
M
Vicente-Olabarría
I
I