Remote cerebellar hemorrhage following repeated lumbar punctures
Abstract Background Remote cerebellar hemorrhage (RCH) is a rare complication in neurosurgery. No case of RCH secondary to repeated lumbar punctures (LPs) has been previously reported. Case presentation A 49-year-old man presented with impaired consciousness following persistent fever. Cerebrospinal...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-06-01
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| Series: | BMC Neurology |
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| Online Access: | https://doi.org/10.1186/s12883-023-03276-6 |
| _version_ | 1827928647991820288 |
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| author | Hai-Yang Wang Zerui Hu Jinming Han Dongsen Wang Qingjian Wu |
| author_facet | Hai-Yang Wang Zerui Hu Jinming Han Dongsen Wang Qingjian Wu |
| author_sort | Hai-Yang Wang |
| collection | DOAJ |
| description | Abstract Background Remote cerebellar hemorrhage (RCH) is a rare complication in neurosurgery. No case of RCH secondary to repeated lumbar punctures (LPs) has been previously reported. Case presentation A 49-year-old man presented with impaired consciousness following persistent fever. Cerebrospinal fluid examination showed high opening pressure, elevated white blood cells, increased protein level, and decreased glucose level, resulting in a diagnosis of bacterial meningoencephalitis. Treatment with repeated LPs and intrathecal injection of ceftriaxone resulted in an improvement in neurological symptoms. However, on day 31 of treatment, brain magnetic resonance image (MRI) showed streaky bleeding in bilateral cerebellum (zebra sign), leading to a diagnosis of RCH. Close observation and repeated brain MRI imaging without specific treatments led to the absorption of bilateral cerebellar hemorrhage, and the patient was discharged with improved neurological symptoms. Repeated brain MRI scans one month after discharge showed that bilateral cerebellar hemorrhage had improved, and had disappeared one year after discharge. Conclusion We reported a rare occurrence of LPs-induced RCH presenting as isolated bilateral inferior cerebellar hemorrhage. Clinicians should be vigilant of the risk factors for RCH, closely monitoring patients' clinical symptoms and neuroimaging findings to determine the need for specialized treatment. Furthermore, this case highlights the importance of ensuring the safety of LPs and managing any potential complications appropriately. |
| first_indexed | 2024-03-13T06:10:41Z |
| format | Article |
| id | doaj.art-ab1967c4f27a40d682399be2706d007b |
| institution | Directory Open Access Journal |
| issn | 1471-2377 |
| language | English |
| last_indexed | 2024-03-13T06:10:41Z |
| publishDate | 2023-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Neurology |
| spelling | doaj.art-ab1967c4f27a40d682399be2706d007b2023-06-11T11:17:21ZengBMCBMC Neurology1471-23772023-06-012311510.1186/s12883-023-03276-6Remote cerebellar hemorrhage following repeated lumbar puncturesHai-Yang Wang0Zerui Hu1Jinming Han2Dongsen Wang3Qingjian Wu4Department of Neurology, Jining No.1 People’s HospitalDepartment of Psychiatry, School of Mental Health, Jining Medical UniversityDepartment of Neurology, Xuanwu Hospital, Capital Medical UniversityClinical Medical College of Jining Medical UniversityDepartment of Emergency, Jining No.1 People’s HospitalAbstract Background Remote cerebellar hemorrhage (RCH) is a rare complication in neurosurgery. No case of RCH secondary to repeated lumbar punctures (LPs) has been previously reported. Case presentation A 49-year-old man presented with impaired consciousness following persistent fever. Cerebrospinal fluid examination showed high opening pressure, elevated white blood cells, increased protein level, and decreased glucose level, resulting in a diagnosis of bacterial meningoencephalitis. Treatment with repeated LPs and intrathecal injection of ceftriaxone resulted in an improvement in neurological symptoms. However, on day 31 of treatment, brain magnetic resonance image (MRI) showed streaky bleeding in bilateral cerebellum (zebra sign), leading to a diagnosis of RCH. Close observation and repeated brain MRI imaging without specific treatments led to the absorption of bilateral cerebellar hemorrhage, and the patient was discharged with improved neurological symptoms. Repeated brain MRI scans one month after discharge showed that bilateral cerebellar hemorrhage had improved, and had disappeared one year after discharge. Conclusion We reported a rare occurrence of LPs-induced RCH presenting as isolated bilateral inferior cerebellar hemorrhage. Clinicians should be vigilant of the risk factors for RCH, closely monitoring patients' clinical symptoms and neuroimaging findings to determine the need for specialized treatment. Furthermore, this case highlights the importance of ensuring the safety of LPs and managing any potential complications appropriately.https://doi.org/10.1186/s12883-023-03276-6Remote cerebellar hemorrhageRepeated lumbar puncturesMeningoencephalitisZebra signMRI |
| spellingShingle | Hai-Yang Wang Zerui Hu Jinming Han Dongsen Wang Qingjian Wu Remote cerebellar hemorrhage following repeated lumbar punctures BMC Neurology Remote cerebellar hemorrhage Repeated lumbar punctures Meningoencephalitis Zebra sign MRI |
| title | Remote cerebellar hemorrhage following repeated lumbar punctures |
| title_full | Remote cerebellar hemorrhage following repeated lumbar punctures |
| title_fullStr | Remote cerebellar hemorrhage following repeated lumbar punctures |
| title_full_unstemmed | Remote cerebellar hemorrhage following repeated lumbar punctures |
| title_short | Remote cerebellar hemorrhage following repeated lumbar punctures |
| title_sort | remote cerebellar hemorrhage following repeated lumbar punctures |
| topic | Remote cerebellar hemorrhage Repeated lumbar punctures Meningoencephalitis Zebra sign MRI |
| url | https://doi.org/10.1186/s12883-023-03276-6 |
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