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Intraventricular blood after "traumatic" lumbar puncture: a report of two cases
1Department of Neurology (A-569), New York Hospital, Cornell Medical Center, NY 10021, USA.
Insights
Blood in a child's brain ventricles after lumbar puncture is a new finding. This can be mistaken for a primary brain bleed, leading to unnecessary medical investigations.
Area of Science:
- Pediatric Radiology
- Neuroimaging
- Neurology
Background:
- Lumbar puncture (LP) is a common diagnostic procedure in children.
- Head computed tomography (CT) is frequently used to evaluate neurological symptoms.
Observation:
- Blood was observed in the lateral ventricles of two children's head CT scans.
- These scans were performed following "traumatic" lumbar punctures.
Findings:
- This is a novel observation not previously reported in medical literature.
- The presence of blood in the ventricles likely resulted from blood migration from the spinal thecal sac.
Implications:
- This finding can be misinterpreted as a primary intraventricular hemorrhage.
- Correctly identifying the source prevents unnecessary diagnostic procedures and patient anxiety.
Abstract:
Blood was detected in the lateral ventricles on head computed tomograms performed after "traumatic" lumbar punctures in two children. This finding has not previously been observed or reported. The likely mechanisms by which blood from the spinal thecal sac reached the ventricles are discussed. This potentially confusing observation, if not correctly accounted for, may lead to an unnecessary, fruitless search for the site of a supposed "primary" intraventricular haemorrhage.