Intracerebral haematoma after lumbar cerebrospinal fluid drainage

Cerebrospinal fluid [CSF] leak is a well recognized complication of basilar skull fracture, skull base surgery and neurootological procedures. Continuous CSF drainage has been a widely accepted procedure to prevent and treat such leaks. Though generally the procedure is innocuous, it can cause complications like headache, nausea, vomiting, subdural bleeding, infection and tension pneumocephalus. Though the development of intracranial subdural haematomas have been reported in a number of cases after deliberate lumbar CSF drainage or inadvertent CSF leak following spine surgery; lumbar CSF drain causing an intracerebral haemorrhage has not been reported previously as per the authors' review of literature. We report a rare case of intracerebral haematoma following lumbar CSF drainage which was managed by timely diagnosis and early evacuation. The authors recommend close neurological monitoring of patients who require continuous lumbar drainage to detect any life-threatening complications

Spinal subdural haematoma following traumatic lumbar puncture in a patient with normal coagulation profile

Spinal subdural haematoma following lumbar puncture is a rare cause of spinal cord compression with very few cases reported in the literature. It is usually associated with some predisposing factors like haemorrhagic diathesis, anticoagulant therapy, vascular malformation, tumour or trauma. The authors report a case of spinal subdural haematoma in a 30-year-old male following a traumatic lumbar puncture with no obvious coagulation disorder. The patient had a poor outcome with minimal improvement in paraparesis at last follow-up, even after timely decompression. Although coagulation abnormalities are commonly found in most of these cases, our case illustrates the fact that spinal subdural haematoma can occur even in the presence of normal coagulation profile and a high index of suspicion with early diagnosis and intervention is warranted to prevent irreversible neurological deterioration, especially following a traumatic lumbar puncture