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诊断性腰椎穿刺后迟发性脑实质内血肿

Delayed Intraparenchymal Hematoma Following Diagnostic Lumbar Puncture.

作者信息

Lapadula Gennaro, Caporlingua Federico, Caporlingua Alessandro, Currà Antonio, Fattapposta Francesco, Missori Paolo

机构信息

Departments of *Neurology and Psychiatry, Neurosurgery †Medico-Surgical Sciences and Biotechnologies, Neurology Unit, "A. Fiorini" Hospital Terracina, LT ‡Neurology and Psychiatry, "Sapienza" University of Rome, Rome, Italy.

出版信息

Neurologist. 2015 Oct;20(4):70-3. doi: 10.1097/NRL.0000000000000055.

Abstract

Lumbar puncture is a safe and commonly performed procedure, with an overall complication rate of 0.1% to 0.5%. Well-known contraindications to lumbar puncture are an intracranial tumor, noncommunicating hydrocephalus, coagulopathy, and ruptured aneurysm with subarachnoid hemorrhage. We report a case of a young man with epilepsy who, after a lumbar puncture performed for research purposes, presented with an intracerebral hematoma and neurological deficits. To the best of our knowledge, post-tap intraparenchymal hematoma is extremely rare and only 1 case has been reported previously. In consideration, all patients undergoing a lumbar puncture should be informed about this possible rare complication, even in the absence of documented hemorrhagic risk factors.

摘要

腰椎穿刺是一种安全且常用的操作,总体并发症发生率为0.1%至0.5%。腰椎穿刺的已知禁忌证包括颅内肿瘤、梗阻性脑积水、凝血功能障碍以及伴有蛛网膜下腔出血的破裂动脉瘤。我们报告一例患有癫痫的年轻男性病例,其在因研究目的进行腰椎穿刺后,出现了脑内血肿和神经功能缺损。据我们所知,穿刺后脑实质内血肿极为罕见,此前仅报道过1例。鉴于此,即使没有记录在案的出血危险因素,所有接受腰椎穿刺的患者都应被告知这种可能的罕见并发症。

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