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Spinal Hernia Repair and Cauda Equina Repositioning After Lumbar Decompression under Three-Dimensional Microscopy: A Case Report and Literature Review
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Symptomatic spinal epidural collections after lumbar puncture in children

B L Koch1, E A Moosbrugger, J C Egelhoff

  • 1Department of Radiology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA. bernadette.koch@cchmc.org

AJNR. American Journal of Neuroradiology
|September 22, 2007
PubMed

Insights

Symptomatic spinal epidural fluid collections after lumbar puncture (LP) are common and appear as CSF leaks on MR imaging. These collections typically resolve with conservative management, showing no serious long-term effects.

Area of Science:

  • Radiology
  • Neurology
  • Pediatric Imaging

Background:

  • Lumbar puncture (LP) can lead to complications like headache and pain.
  • Rarely, LP may cause subdural, epidural, or subarachnoid hemorrhage.
  • Asymptomatic cerebrospinal fluid (CSF) leakage is common in infants post-LP.

Purpose of the Study:

  • To report MR imaging findings and clinical outcomes.
  • To analyze 25 symptomatic patients with spinal epidural collections after LP.
  • To differentiate CSF leak from hemorrhage in post-LP collections.

Main Methods:

  • Retrospective review of MR imaging and clinical records.
  • Inclusion of 25 pediatric patients with new symptoms post-LP.
  • Analysis of spinal epidural collection characteristics.

Main Results:

  • All patients exhibited abnormal dorsal spinal epidural collections, typically isointense to CSF.
  • Collections frequently caused anterior dural displacement and subarachnoid space effacement.
  • A characteristic "floating" appearance of epidural fat was observed; symptoms resolved with conservative management.

Conclusions:

  • Symptomatic epidural fluid collections post-LP are often extensive and may affect the thecal sac.
  • These collections usually represent CSF leaks, not hemorrhage, and are not typically linked to difficult LPs.
  • Symptoms and signs resolve over time with conservative management, without significant sequelae.
Abstract

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