Fatal intracranial extension of spinal hemorrhage after lumbar puncture

Lumbar puncture (LP) is sometimes performed in addition to computed tomography (CT) to exclude hemorrhage prior to anticoagulation for suspected cerebral ischemia. The LP may be complicated by spinal hemorrhage during subsequent anticoagulation. We report such a case with an eventually fatal outcome due to intracranial extension of blood. On balance, the use of LP in addition to CT in this setting appears to be unwise.