Quadriplegia secondary to hematoma after lateral C-1, C-2 puncture in a leukemic child.

Epidural, subdural, and intramedullary hemorrhage developed after lateral cervical (C-1, C-2) puncture in a thrombocytopenic patient with meningeal leukemia and increased intracranial pressure. Aggressive platelet support before the procedure did not prevent the hemorrhagic complication. Complete recovery from total motor paralysis with respiratory arrest followed immediate surgical decompression and continuing platelet support. The potential dangers of otherwise minor procedures in compromised patients are reiterated. Neurological recovery as seen here argues for immediate surgical intervention with the development of such potentially life-threatening events.