Abstract

EXCEPT for some danger of uncal herniation in patients with increased intracranial pressure and of deterioration in patients with paraparesis, little risk is generally ascribed to lumbar puncture. Lumbar puncture From the Neurosurgery Service, Department of Surgery (Drs Messer, Forshan, and Hughes), and the Department of Neurology (Dr Brust), Harlem Hospital Center, and the departments of neurosurgery (Drs Messer and Hughes) and neurology (Dr Brust), Columbia University College of Physicians and Surgeons, New York. Reprint requests to 22 Charles St, New York, NY 10014 (Dr Messer). can initiate a train of serious events in a patient receiving anticoagulants, as illustrated in this report. Report of a Case A 51-year-old woman with rheumatic heart disease had had a presumed cerebral embolus with right hemiparesis in March 1973. Two months later, she underwent mitral comissurotomy. In September 1973, she had an episode of dysarthria and confusion lasting several

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