Central Nervous System Hemorrhage Following Lumbar Puncture for Intrathecal Chemotherapy in a Pediatric Oncology Patient

Onur Balaban, Giorgio Veneziano, Richard S. Cartabuke, Joseph D. Tobias


In the pediatric oncology patients, a lumbar puncture (LP) may be performed to administer intrathecal chemotherapy and obtain cerebrospinal fluid (CSF) samples. Although it is generally safe and devoid of adverse effects, with insertion and advancement of the spinal needle, there may be a risk of bleeding especially in patients with inherited or acquired defects of coagulation function. We report a 3-year-old child with acute lymphoblastic leukemia and associated thrombocytopenia who developed spinal and intraventricular hemorrhage following an LP for the administration of intrathecal chemotherapy. The etiology of such complications is discussed, previous reports are reviewed, and guidelines are suggested to prevent these complications.

J Med Cases. 2016;7(10):461-466
doi: http://dx.doi.org/10.14740/jmc2656w


Subarachnoid hemorrhage; Thrombocytopenia; Lumbar puncture; Acute lymphoblastic leukemia; Pediatric

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