Paraparesis after lumbar puncture in a male with leukemia

A diagnostic lumbar puncture was performed in a 12-year-old male with acute lymphoblastic leukemia. Because of thrombocytopenia (platelet count 42,000 /mm(3)), a platelet transfusion was given immediately before the lumbar pun cture. However, the platelet count was not re-examined. The patient develop ed progressive paraparesis shortly after the lumbar puncture. Magnetic reso nance imaging revealed an extensive spinal subdural hematoma from the T2 to S2 level. This case report illustrates the sometimes dramatic consequences of lumbar puncture in patients with childhood leukemia. Guidelines for the examination of the platelet count and correction of thrombocytopenia befor e lumbar puncture are discussed. (C) 2000 by Elsevier Science Inc, All righ ts reserved.