Cerebrospinal fluid dissecting into spinal epidural space after lumbar puncture causing cauda equina syndrome: Review of literature and illustrative case

Amin Amini, James K. Liu, Peter Kan, Douglas L. Brockmeyer

Research output: Contribution to journalReview article

Abstract

Objects: We report a case of epidural cerebrospinal fluid (CSF) leak after lumbar puncture caused by CSF dissecting into the spinal epidural space. The incidence of this phenomenon may be higher than suspected, although most cases may remain asymptomatic. Materials and methods: A 4-year-old girl with new-onset seizure underwent a diagnostic lumbar puncture, the results of which were normal; 3 h later, she began experiencing severe low-pressure headaches and lower back pain, bilateral lower extremity weakness, numbness, and pain, and urinary retention when upright. Spinal MRI demonstrated extensive epidural CSF collection posterior to the thecal sac extending from the cervicothoracic junction to the sacrum. After 48 h in the supine position and gradual mobilization, the patient had complete resolution of symptoms and no neurological sequelae. Conclusion: Patients usually recover without any neurological deficits after conservative treatment. Prone or lateral decubitus positioning immediately after lumbar puncture may decrease the incidence of this phenomenon.

Original languageEnglish (US)
Pages (from-to)1639-1641
Number of pages3
JournalChild's Nervous System
Volume22
Issue number12
DOIs
StatePublished - Dec 2006

Keywords

  • Cauda equina syndrome
  • Cerebrospinal fluid leak
  • Epidural collection
  • Lumbar puncture

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Clinical Neurology

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