Case of the Week
Section Editors: Matylda Machnowska1 and Anvita Pauranik2
1University of Toronto, Toronto, Ontario, Canada
2BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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December 19, 2011
Acute Post-traumatic Spinal Subarachnoid Hematoma
- Intraspinal hematoma is an uncommon complication of lumbar puncture.
- It can occur in the epidural, subdural, and subarachnoid compartments; however, it is most commonly seen in the epidural space.
- Patients with thrombocytopenia or coagulation disorders, on blood thinners, and immunocompromised patients with platelet dysfunction (such as those on protease inhibitors) are predisposed.
- Key Diagnostic Features: Abnormal signal intensity within the spinal canal consistent with hemorrhage, typically in the epidural, and less commonly in the subdural and subarachnoid space, is seen. Mass effect on the cord and nerve roots can be seen.
- DDx: Other causes of epidural and subdural collections, such as infected collections.
- Rx: When large and symptomatic, surgical decompression
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