Abstract
We present a rare case of spinal subdural hematoma induced by guidewire-based lumbar drainage in a subarachnoid hemorrhage patient with a ruptured intracranial aneurysm. Decreased muscle strength and muscle tension of bilateral lower limbs were noted, and an MRI confirmed the spinal subdural hematoma from the sacral to the thoracic segments. The spinal subdural hematoma evacuation and spinal canal decompression were performed by laminectomy. However, the patient did not benefit from the surgery and developed lower limb muscle atrophy. The complication of the spinal subdural hematoma after lumbar drainage is extremely rare; only limited approaches are available for the treatment of spinal hematoma to improve the outcome and avoid severe consequences. Thus, the present case might suggest refraining from use of a guidewire during lumbar drainage for the prevention of spinal subdural hematoma and close observation of the related symptoms and signs for the early detection of spinal hematoma after the procedure. In addition, full decompression can be performed by complete hematoma evacuation and laminectomy of related segments for the treatment of spinal subdural hematoma induced by lumbar drainage.
Highlights
Lumbar puncture (LP) is a procedure commonly used to diagnose neurological dysfunction and therapeutically decrease cerebrospinal fluid (CSF) volume
The most frequently observed complications include post-LP headache and local structural injury. Severe complications such as spinal hematoma formation that could lead to myelopathy or cauda equina syndrome are rarely observed; such complications should be diagnosed and treated immediately to avoid irreversible paralysis or death
A subarachnoid hemorrhage (Hunt and Hess Grade IV) with intraventricular hemorrhage and obstructive hydrocephalus was observed on a head CT scan
Summary
Lumbar puncture (LP) is a procedure commonly used to diagnose neurological dysfunction and therapeutically decrease cerebrospinal fluid (CSF) volume. The most frequently observed complications include post-LP headache and local structural injury. Severe complications such as spinal hematoma formation that could lead to myelopathy or cauda equina syndrome are rarely observed; such complications should be diagnosed and treated immediately to avoid irreversible paralysis or death. Existing reports have not produced efficient solutions, and prevention of such complications is rarely mentioned [1]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
