Epidural hematoma and paraplegia after numerous lumbar punctures

Abstract

Lumbar puncture for attempted spinal anesthesia caused an epidural hemorrhage with cord compression and permanent neurologic damage in a patient with normal blood coagulation. Intraspinal hematoma formation and subsequent paraplegia have been reported to occur after spinal anesthesia in a patient with a blood dyscrasia, after continuous epidural anesthesia in a heparinized patient, after lumbar puncture in a leukemic child, after trauma to the vertebral column, and spontaneously. To the authors' knowledge, no instance of spinal epidural hematoma folloing lumbar puncture in a patient whose blood coagulation is normal has previously been reported. 13 references are cited.