Pediatric post-dural puncture headache and paraplegia

Headache. 2024 Jul-Aug;64(7):865-868. doi: 10.1111/head.14749. Epub 2024 Jun 11.

Abstract

A cerebrospinal fluid (CSF) leak developed in a 14-year-old girl and a 12-year-old boy following a diagnostic lumbar puncture. Two days and sixteen years later, respectively, paraplegia developed due to a functional disorder. Imaging revealed an extensive extradural CSF collection in both patients and digital subtraction myelography was required to pinpoint the exact site of a ventral dural puncture hole where the lumbar spinal needle had gone "through and through" the dural sac. The CSF leak was complicated by cortical vein thrombosis in one patient. Both patients underwent uneventful surgical repair of the ventral dural puncture hole with prompt resolution of the paraplegia. Iatrogenic ventral CSF leaks may become exceptionally long standing and may be complicated by paraplegia on a functional basis both in the acute and chronic phases.

Keywords: cerebrospinal fluid; cortical vein thrombosis; intracranial hypotension; pediatric headache; post‐dural puncture headache.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Cerebrospinal Fluid Leak / complications
  • Cerebrospinal Fluid Leak / diagnostic imaging
  • Cerebrospinal Fluid Leak / etiology
  • Child
  • Female
  • Humans
  • Male
  • Paraplegia* / etiology
  • Post-Dural Puncture Headache* / etiology
  • Post-Dural Puncture Headache* / therapy
  • Spinal Puncture / adverse effects