Medullary Infarction Leading to Locked-In Syndrome Following Lumbar Puncture in a Patient with Basilar Invagination.
World Neurosurg
; 137: 292-295, 2020 05.
Article
in En
| MEDLINE
| ID: mdl-32068170
BACKGROUND: Lumbar puncture is a common procedure that can be safely performed in most patients. Certain populations may have increased risk for complications following lumbar puncture, but the significance of basilar invagination is often underappreciated. CASE DESCRIPTION: A 45-year-old woman with basilar invagination received multiple lumbar punctures in the workup of acute meningitis. Preprocedural computed tomography was obtained. Following lumbar puncture, the patient developed locked-in syndrome. Magnetic resonance imaging obtained several days later demonstrated severe compression and infarction of the medulla and inferior cerebellum by the odontoid process and ectopic cerebellar tonsils. The patient was transferred but at this point, surgical decompression was not possible. She did not regain significant neurologic function. CONCLUSIONS: Basilar invagination is a risk factor for devastating neurologic complications following lumbar puncture. Awareness of this complication and prompt recognition of its occurrence may prevent future morbidity of lumbar puncture in patients with basilar invagination.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Platybasia
/
Postoperative Complications
/
Spinal Puncture
/
Medulla Oblongata
/
Brain Stem Infarctions
/
Locked-In Syndrome
/
Meningitis, Pneumococcal
Type of study:
Etiology_studies
/
Risk_factors_studies
Limits:
Female
/
Humans
/
Middle aged
Language:
En
Journal:
World Neurosurg
Journal subject:
NEUROCIRURGIA
Year:
2020
Document type:
Article
Affiliation country:
United States
Country of publication:
United States