Dural tear from diagnostic lumbar puncture followed by long-term morbidity: a case report

Background Lumbar punctures are performed in different medical settings and are a key procedure in the diagnosis of several neurological conditions. Complications are rare and generally self-limiting. There are no reports of symptomatic accumulation of fluid in the epidural space after lumbar punctu...
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Autor*in:	Haugstvedt, Aleksander Fjeld [verfasserIn] Havsteen, Inger Birgitte [verfasserIn] Christensen, Hanne [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2020

Schlagwörter:	Spinal puncture Post dural-puncture headache General neurology

Übergeordnetes Werk:	Enthalten in: Neurological research and practice - [London] : BioMed Central, 2019, 2(2020), 1 vom: 08. Okt.
Übergeordnetes Werk:	volume:2 ; year:2020 ; number:1 ; day:08 ; month:10

Links:	Volltext

DOI / URN:	10.1186/s42466-020-00083-z

Katalog-ID:	SPR041233506

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520			\|a Background Lumbar punctures are performed in different medical settings and are a key procedure in the diagnosis of several neurological conditions. Complications are rare and generally self-limiting. There are no reports of symptomatic accumulation of fluid in the epidural space after lumbar puncture in adults and there are no studies on long-term outcome after post dural puncture headache (PDPH). Case A lumbar puncture was performed in a 29 y.o. slender woman with unspecific symptoms to rule out neuro-infection. Next day MRI showed substantial accumulation of CSF in the epidural space from C2 to the sacrum dislocating the spinal chord in the spinal canal. The condition was ameliorated by epidural blood-patching. At 5 months she was still impaired by severe orthostatic headache. Conclusions The only plausible explanation for the massive CSF leak was a dural tear occurring during multiple attempts of lumbar puncture. Anterior dislocation of the spinal chord due to CSF leak is not a recognised complication to lumbar puncture. This complication was followed by long-term disability in our case. The diagnosis can be made by MRI. A difficult procedure with several attempts and use of traumatic technique may increase risk of this complication.
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allfields	10.1186/s42466-020-00083-z doi (DE-627)SPR041233506 (SPR)s42466-020-00083-z-e DE-627 ger DE-627 rakwb eng 610 ASE 610 ASE Haugstvedt, Aleksander Fjeld verfasserin aut Dural tear from diagnostic lumbar puncture followed by long-term morbidity: a case report 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Lumbar punctures are performed in different medical settings and are a key procedure in the diagnosis of several neurological conditions. Complications are rare and generally self-limiting. There are no reports of symptomatic accumulation of fluid in the epidural space after lumbar puncture in adults and there are no studies on long-term outcome after post dural puncture headache (PDPH). Case A lumbar puncture was performed in a 29 y.o. slender woman with unspecific symptoms to rule out neuro-infection. Next day MRI showed substantial accumulation of CSF in the epidural space from C2 to the sacrum dislocating the spinal chord in the spinal canal. The condition was ameliorated by epidural blood-patching. At 5 months she was still impaired by severe orthostatic headache. Conclusions The only plausible explanation for the massive CSF leak was a dural tear occurring during multiple attempts of lumbar puncture. Anterior dislocation of the spinal chord due to CSF leak is not a recognised complication to lumbar puncture. This complication was followed by long-term disability in our case. The diagnosis can be made by MRI. A difficult procedure with several attempts and use of traumatic technique may increase risk of this complication. Spinal puncture (dpeaa)DE-He213 Post dural-puncture headache (dpeaa)DE-He213 General neurology (dpeaa)DE-He213 Havsteen, Inger Birgitte verfasserin aut Christensen, Hanne verfasserin aut Enthalten in Neurological research and practice [London] : BioMed Central, 2019 2(2020), 1 vom: 08. Okt. (DE-627)1038162947 (DE-600)2947493-0 2524-3489 nnns volume:2 year:2020 number:1 day:08 month:10 https://dx.doi.org/10.1186/s42466-020-00083-z kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 2 2020 1 08 10
spelling	10.1186/s42466-020-00083-z doi (DE-627)SPR041233506 (SPR)s42466-020-00083-z-e DE-627 ger DE-627 rakwb eng 610 ASE 610 ASE Haugstvedt, Aleksander Fjeld verfasserin aut Dural tear from diagnostic lumbar puncture followed by long-term morbidity: a case report 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Lumbar punctures are performed in different medical settings and are a key procedure in the diagnosis of several neurological conditions. Complications are rare and generally self-limiting. There are no reports of symptomatic accumulation of fluid in the epidural space after lumbar puncture in adults and there are no studies on long-term outcome after post dural puncture headache (PDPH). Case A lumbar puncture was performed in a 29 y.o. slender woman with unspecific symptoms to rule out neuro-infection. Next day MRI showed substantial accumulation of CSF in the epidural space from C2 to the sacrum dislocating the spinal chord in the spinal canal. The condition was ameliorated by epidural blood-patching. At 5 months she was still impaired by severe orthostatic headache. Conclusions The only plausible explanation for the massive CSF leak was a dural tear occurring during multiple attempts of lumbar puncture. Anterior dislocation of the spinal chord due to CSF leak is not a recognised complication to lumbar puncture. This complication was followed by long-term disability in our case. The diagnosis can be made by MRI. A difficult procedure with several attempts and use of traumatic technique may increase risk of this complication. Spinal puncture (dpeaa)DE-He213 Post dural-puncture headache (dpeaa)DE-He213 General neurology (dpeaa)DE-He213 Havsteen, Inger Birgitte verfasserin aut Christensen, Hanne verfasserin aut Enthalten in Neurological research and practice [London] : BioMed Central, 2019 2(2020), 1 vom: 08. Okt. (DE-627)1038162947 (DE-600)2947493-0 2524-3489 nnns volume:2 year:2020 number:1 day:08 month:10 https://dx.doi.org/10.1186/s42466-020-00083-z kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 2 2020 1 08 10
allfields_unstemmed	10.1186/s42466-020-00083-z doi (DE-627)SPR041233506 (SPR)s42466-020-00083-z-e DE-627 ger DE-627 rakwb eng 610 ASE 610 ASE Haugstvedt, Aleksander Fjeld verfasserin aut Dural tear from diagnostic lumbar puncture followed by long-term morbidity: a case report 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Lumbar punctures are performed in different medical settings and are a key procedure in the diagnosis of several neurological conditions. Complications are rare and generally self-limiting. There are no reports of symptomatic accumulation of fluid in the epidural space after lumbar puncture in adults and there are no studies on long-term outcome after post dural puncture headache (PDPH). Case A lumbar puncture was performed in a 29 y.o. slender woman with unspecific symptoms to rule out neuro-infection. Next day MRI showed substantial accumulation of CSF in the epidural space from C2 to the sacrum dislocating the spinal chord in the spinal canal. The condition was ameliorated by epidural blood-patching. At 5 months she was still impaired by severe orthostatic headache. Conclusions The only plausible explanation for the massive CSF leak was a dural tear occurring during multiple attempts of lumbar puncture. Anterior dislocation of the spinal chord due to CSF leak is not a recognised complication to lumbar puncture. This complication was followed by long-term disability in our case. The diagnosis can be made by MRI. A difficult procedure with several attempts and use of traumatic technique may increase risk of this complication. Spinal puncture (dpeaa)DE-He213 Post dural-puncture headache (dpeaa)DE-He213 General neurology (dpeaa)DE-He213 Havsteen, Inger Birgitte verfasserin aut Christensen, Hanne verfasserin aut Enthalten in Neurological research and practice [London] : BioMed Central, 2019 2(2020), 1 vom: 08. Okt. (DE-627)1038162947 (DE-600)2947493-0 2524-3489 nnns volume:2 year:2020 number:1 day:08 month:10 https://dx.doi.org/10.1186/s42466-020-00083-z kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 2 2020 1 08 10
allfieldsGer	10.1186/s42466-020-00083-z doi (DE-627)SPR041233506 (SPR)s42466-020-00083-z-e DE-627 ger DE-627 rakwb eng 610 ASE 610 ASE Haugstvedt, Aleksander Fjeld verfasserin aut Dural tear from diagnostic lumbar puncture followed by long-term morbidity: a case report 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Lumbar punctures are performed in different medical settings and are a key procedure in the diagnosis of several neurological conditions. Complications are rare and generally self-limiting. There are no reports of symptomatic accumulation of fluid in the epidural space after lumbar puncture in adults and there are no studies on long-term outcome after post dural puncture headache (PDPH). Case A lumbar puncture was performed in a 29 y.o. slender woman with unspecific symptoms to rule out neuro-infection. Next day MRI showed substantial accumulation of CSF in the epidural space from C2 to the sacrum dislocating the spinal chord in the spinal canal. The condition was ameliorated by epidural blood-patching. At 5 months she was still impaired by severe orthostatic headache. Conclusions The only plausible explanation for the massive CSF leak was a dural tear occurring during multiple attempts of lumbar puncture. Anterior dislocation of the spinal chord due to CSF leak is not a recognised complication to lumbar puncture. This complication was followed by long-term disability in our case. The diagnosis can be made by MRI. A difficult procedure with several attempts and use of traumatic technique may increase risk of this complication. Spinal puncture (dpeaa)DE-He213 Post dural-puncture headache (dpeaa)DE-He213 General neurology (dpeaa)DE-He213 Havsteen, Inger Birgitte verfasserin aut Christensen, Hanne verfasserin aut Enthalten in Neurological research and practice [London] : BioMed Central, 2019 2(2020), 1 vom: 08. Okt. (DE-627)1038162947 (DE-600)2947493-0 2524-3489 nnns volume:2 year:2020 number:1 day:08 month:10 https://dx.doi.org/10.1186/s42466-020-00083-z kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 2 2020 1 08 10
allfieldsSound	10.1186/s42466-020-00083-z doi (DE-627)SPR041233506 (SPR)s42466-020-00083-z-e DE-627 ger DE-627 rakwb eng 610 ASE 610 ASE Haugstvedt, Aleksander Fjeld verfasserin aut Dural tear from diagnostic lumbar puncture followed by long-term morbidity: a case report 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Lumbar punctures are performed in different medical settings and are a key procedure in the diagnosis of several neurological conditions. Complications are rare and generally self-limiting. There are no reports of symptomatic accumulation of fluid in the epidural space after lumbar puncture in adults and there are no studies on long-term outcome after post dural puncture headache (PDPH). Case A lumbar puncture was performed in a 29 y.o. slender woman with unspecific symptoms to rule out neuro-infection. Next day MRI showed substantial accumulation of CSF in the epidural space from C2 to the sacrum dislocating the spinal chord in the spinal canal. The condition was ameliorated by epidural blood-patching. At 5 months she was still impaired by severe orthostatic headache. Conclusions The only plausible explanation for the massive CSF leak was a dural tear occurring during multiple attempts of lumbar puncture. Anterior dislocation of the spinal chord due to CSF leak is not a recognised complication to lumbar puncture. This complication was followed by long-term disability in our case. The diagnosis can be made by MRI. A difficult procedure with several attempts and use of traumatic technique may increase risk of this complication. Spinal puncture (dpeaa)DE-He213 Post dural-puncture headache (dpeaa)DE-He213 General neurology (dpeaa)DE-He213 Havsteen, Inger Birgitte verfasserin aut Christensen, Hanne verfasserin aut Enthalten in Neurological research and practice [London] : BioMed Central, 2019 2(2020), 1 vom: 08. Okt. (DE-627)1038162947 (DE-600)2947493-0 2524-3489 nnns volume:2 year:2020 number:1 day:08 month:10 https://dx.doi.org/10.1186/s42466-020-00083-z kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 2 2020 1 08 10
language	English
source	Enthalten in Neurological research and practice 2(2020), 1 vom: 08. Okt. volume:2 year:2020 number:1 day:08 month:10
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topic_facet	Spinal puncture Post dural-puncture headache General neurology
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authorswithroles_txt_mv	Haugstvedt, Aleksander Fjeld @@aut@@ Havsteen, Inger Birgitte @@aut@@ Christensen, Hanne @@aut@@
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author	Haugstvedt, Aleksander Fjeld
spellingShingle	Haugstvedt, Aleksander Fjeld ddc 610 misc Spinal puncture misc Post dural-puncture headache misc General neurology Dural tear from diagnostic lumbar puncture followed by long-term morbidity: a case report
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topic_title	610 ASE Dural tear from diagnostic lumbar puncture followed by long-term morbidity: a case report Spinal puncture (dpeaa)DE-He213 Post dural-puncture headache (dpeaa)DE-He213 General neurology (dpeaa)DE-He213
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title	Dural tear from diagnostic lumbar puncture followed by long-term morbidity: a case report
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title_full	Dural tear from diagnostic lumbar puncture followed by long-term morbidity: a case report
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title_sort	dural tear from diagnostic lumbar puncture followed by long-term morbidity: a case report
title_auth	Dural tear from diagnostic lumbar puncture followed by long-term morbidity: a case report
abstract	Background Lumbar punctures are performed in different medical settings and are a key procedure in the diagnosis of several neurological conditions. Complications are rare and generally self-limiting. There are no reports of symptomatic accumulation of fluid in the epidural space after lumbar puncture in adults and there are no studies on long-term outcome after post dural puncture headache (PDPH). Case A lumbar puncture was performed in a 29 y.o. slender woman with unspecific symptoms to rule out neuro-infection. Next day MRI showed substantial accumulation of CSF in the epidural space from C2 to the sacrum dislocating the spinal chord in the spinal canal. The condition was ameliorated by epidural blood-patching. At 5 months she was still impaired by severe orthostatic headache. Conclusions The only plausible explanation for the massive CSF leak was a dural tear occurring during multiple attempts of lumbar puncture. Anterior dislocation of the spinal chord due to CSF leak is not a recognised complication to lumbar puncture. This complication was followed by long-term disability in our case. The diagnosis can be made by MRI. A difficult procedure with several attempts and use of traumatic technique may increase risk of this complication.
abstractGer	Background Lumbar punctures are performed in different medical settings and are a key procedure in the diagnosis of several neurological conditions. Complications are rare and generally self-limiting. There are no reports of symptomatic accumulation of fluid in the epidural space after lumbar puncture in adults and there are no studies on long-term outcome after post dural puncture headache (PDPH). Case A lumbar puncture was performed in a 29 y.o. slender woman with unspecific symptoms to rule out neuro-infection. Next day MRI showed substantial accumulation of CSF in the epidural space from C2 to the sacrum dislocating the spinal chord in the spinal canal. The condition was ameliorated by epidural blood-patching. At 5 months she was still impaired by severe orthostatic headache. Conclusions The only plausible explanation for the massive CSF leak was a dural tear occurring during multiple attempts of lumbar puncture. Anterior dislocation of the spinal chord due to CSF leak is not a recognised complication to lumbar puncture. This complication was followed by long-term disability in our case. The diagnosis can be made by MRI. A difficult procedure with several attempts and use of traumatic technique may increase risk of this complication.
abstract_unstemmed	Background Lumbar punctures are performed in different medical settings and are a key procedure in the diagnosis of several neurological conditions. Complications are rare and generally self-limiting. There are no reports of symptomatic accumulation of fluid in the epidural space after lumbar puncture in adults and there are no studies on long-term outcome after post dural puncture headache (PDPH). Case A lumbar puncture was performed in a 29 y.o. slender woman with unspecific symptoms to rule out neuro-infection. Next day MRI showed substantial accumulation of CSF in the epidural space from C2 to the sacrum dislocating the spinal chord in the spinal canal. The condition was ameliorated by epidural blood-patching. At 5 months she was still impaired by severe orthostatic headache. Conclusions The only plausible explanation for the massive CSF leak was a dural tear occurring during multiple attempts of lumbar puncture. Anterior dislocation of the spinal chord due to CSF leak is not a recognised complication to lumbar puncture. This complication was followed by long-term disability in our case. The diagnosis can be made by MRI. A difficult procedure with several attempts and use of traumatic technique may increase risk of this complication.
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title_short	Dural tear from diagnostic lumbar puncture followed by long-term morbidity: a case report
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score	7.3982077

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Dural tear from diagnostic lumbar puncture followed by long-term morbidity: a case report

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