Document Detail


Life-threatening intracranial hypotension after diagnostic lumbar puncture.
MedLine Citation:
PMID:  11917976     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Intracranial hypotension syndrome as a complication of diagnostic lumbar puncture is a rarely observed entity. Intracranial hypotension syndrome is characterized by postural headache, neck pain/stiffness, blurred vision, nausea, vomiting, clouding of consciousness, dizziness and vertigo. The majority of cases resolve spontaneously with conservative treatment. Rarely, epidural blood patch is required. We report a 41-year-old man with multiple sclerosis, who developed intracranial hypotension syndrome after diagnostic lumbar puncture and who did not respond to conservative treatment. A subdural hematoma was subsequently found, when the patient showed considerable worsening of clinical conditions with life-threatening symptoms. Surgical evacuation of the subdural hematoma was not sufficient to improve significantly the patient's conditions, while complete symptoms remission was achieved 12 hours after epidural blood patch. We stress the need for epidural blood patch in any case of post-diagnostic lumbar puncture postural headache which does not resolve with conservative therapy.
Authors:
A Francia; P Parisi; A M Vitale; V Esposito
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology     Volume:  22     ISSN:  1590-1874     ISO Abbreviation:  Neurol. Sci.     Publication Date:  2001 Oct 
Date Detail:
Created Date:  2002-03-28     Completed Date:  2002-04-25     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  100959175     Medline TA:  Neurol Sci     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  385-9     Citation Subset:  IM    
Affiliation:
Third Clinic of Neurology, Department of Neurological Sciences, La Sapienza University, Rome, Italy.
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MeSH Terms
Descriptor/Qualifier:
Adult
Blood Patch, Epidural
Brain / pathology,  physiopathology
Encephalocele / etiology,  pathology,  physiopathology
Headache / pathology,  physiopathology
Hematoma, Subdural / etiology*,  pathology,  physiopathology*
Humans
Intracranial Hypotension / etiology*,  pathology,  physiopathology*
Magnetic Resonance Imaging
Male
Multiple Sclerosis / diagnosis,  physiopathology
Postoperative Complications / etiology*,  pathology,  physiopathology*
Spinal Puncture / adverse effects*
Subarachnoid Space / pathology,  physiopathology
Treatment Outcome
Comments/Corrections
Comment In:
Neurol Sci. 2001 Oct;22(5):411-2;DISCUSSION 412.   [PMID:  11917983 ]

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