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Neurological Sciences

, Volume 22, Issue 5, pp 385–389 | Cite as

Life-threatening intracranial hypotension after diagnostic lumbar puncture

  • A. Francia
  • P. Parisi
  • A. M. Vitale
  • V. Esposito
CASE REPORT

Abstract

Intracranial hypotension syndrome as a complication of diagnostic lumbar puncture is a rarely observed entity. Intracranial hypotension syndrome is characterized by postural headache, neck pain/stiffness, blurred vision, nausea, vomiting, clouding of consciousness, dizziness and vertigo. The majority of cases resolve spontaneously with conservative treatment. Rarely, epidural blood patch is required. We report a 41-year-old man with multiple sclerosis, who developed intracranial hypotension syndrome after diagnostic lumbar puncture and who did not respond to conservative treatment. A subdural hematoma was subsequently found, when the patient showed considerable worsening of clinical conditions with life-threatening symptoms. Surgical evacuation of the subdural hematoma was not sufficient to improve significantly the patient's conditions, while complete symptoms remission was achieved 12 hours after epidural blood patch. We stress the need for epidural blood patch in any case of post-diagnostic lumbar puncture postural headache which does not resolve with conservative therapy.

Key words Intracranial hypotension syndrome Epidural blood patch Diagnostic lumbar puncture Subdural hematoma Postural headache 

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Copyright information

© Springer-Verlag Italia 2001

Authors and Affiliations

  • A. Francia
    • 1
  • P. Parisi
    • 1
  • A. M. Vitale
    • 1
  • V. Esposito
    • 2
  1. 1.Third Clinic of Neurology, Department of Neurological Sciences, La Sapienza University, Viale dell'Università 30, I-00185 Rome, ItalyItaly
  2. 2.First Section of Neurosurgery, Department of Neurological Sciences, La Sapienza University, Rome, ItalyItaly

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