J Clin Neurol.  2009 Jun;5(2):95-96. 10.3988/jcn.2009.5.2.95.

Acute Subdural Hematoma Following Spinal Cerebrospinal Fluid Drainage in a Patient with Freezing of Gait

• Kim HJ
• Cho YJ
• Cho JY
• Lee DH
• Hong KS

• KMID: 2287661
• DOI: http://doi.org/10.3988/jcn.2009.5.2.95

Abstract

BACKGROUND: Headache is a common complication of lumbar puncture (LP). Although in most cases post-LP headaches are not severe and have a benign course, they can also be a manifestation of a potentially life-threatening complication such as subdural hematoma (SDH).
CASE REPORT
We describe a patient in whom a massive SDH developed after LP and cerebrospinal fluid (CSF) drainage, which were performed during the diagnostic evaluation of freezing of gait.
CONCLUSIONS
SDH should not be excluded from the differential diagnosis of headache following LP, especially when there is a loss of CSF.

Keyword

freezing of gait; subdural hematoma; lumbar puncture; cerebrospinal fluid drainage; headache

MeSH Terms

Diagnosis, Differential
Drainage
Freezing
Gait
Headache
Hematoma, Subdural
Hematoma, Subdural, Acute
Humans
Spinal Puncture

Figure

• 

  Fig. 1 Brain MRI and CT (A) Brain MRI performed on the first admission revealing multiple ischemic changes in the periventricular white matter, bilateral basal ganglia, and pons, and diffuse cerebral atrophy with ventriculomegaly. (B) A brain CT scan taken before LP during the second admission shows no signs of hemorrhage. (C) A brain CT scan taken 5 days after LP, showing left frontotemporoparietal SDH with midline shifting. LP: lumbar puncture, SDH: subdural hematoma.

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