Lavie F, Hervé D, Le Ber I, Brault J L, Sangla S, de Broucker T
Service de Neurologie, Hôpital Delafontaine, Saint-Denis.
Rev Neurol (Paris). 1998 Oct;154(10):703-5.
A chronic, bilateral, intra-cranial subdural hematoma was diagnosed in a 28 year old man. A standard diagnostic spinal tap had been performed 6 weeks before. There was no other etiologic factor. Intra-cranial subdural hematoma is a rare complication of either diagnostic, therapeutic, or accidental lumbar puncture. Extensive literature review disclosed the description of 49 other cases, including only 3 cases following a standard diagnostic lumbar puncture. Outcome was fatal in 9 of them. The possibility of an intra-cranial subdural hematoma has to be considered in case of prolonged or unusual headache following a lumbar puncture, even with a headache-free period, knowing the emergency of the surgical therapeutic procedure. The most likely mechanism is subdural venous bleeding induced by the chronic intracranial hypotension due to the persisting lumbar meningeal wound.
一名28岁男性被诊断为慢性双侧颅内硬膜下血肿。6周前曾进行过一次标准诊断性腰椎穿刺。无其他病因。颅内硬膜下血肿是诊断性、治疗性或意外性腰椎穿刺的一种罕见并发症。广泛的文献回顾发现了另外49例相关病例的描述，其中仅3例发生在标准诊断性腰椎穿刺之后。其中9例预后不良。腰椎穿刺后出现长时间或异常头痛时，即使有头痛缓解期，考虑到手术治疗的紧迫性，也必须考虑颅内硬膜下血肿的可能性。最可能的机制是由于腰椎脑膜伤口持续存在导致慢性颅内低压引起的硬膜下静脉出血。
