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Safety of lumbar puncture in patients with hemophilia
R Silverman1, T Kwiatkowski, S Bernstein
1Department of Emergency Medicine, Long Island Jewish Medical Center, Albert Einstein College of Medicine, New Hyde Park, New York.
Study Objective:
To determine the safety of lumbar puncture in patients with hemophilia who are pretreated with clotting factor.
Design:
Retrospective analysis of medical records between 1980 and 1990.
Setting:
Three hospitals, each serving as a regional hemophilia center.
Participants:
Thirty-three patients with hemophilia A or B who received one or more lumbar puncture.
Intervention:
All patients received replacement of deficient factor before the lumbar puncture. Serious post-lumbar puncture complications were defined as motor or sensory deficits, incontinence, or documented intraspinal hemorrhage.
Results:
Thirty-three patients with hemophilia A or B received a total of 52 lumbar punctures during the study period. Thirty of 33 patients (91%) had severe baseline factor deficiency, two (6%) had moderate deficiency, and one (3%) had mild deficiency. There were no serious complications reported as a result of the lumbar puncture. The 95% confidence interval for the risk of a serious complication was 0% to 5.8%.
Conclusion:
With adequate factor replacement, a lumbar puncture can be done safely in patients with hemophilia.