Acute subdural hematoma and death following lateral cervical spinal puncture

Case report

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✓ An acute subdural hematoma dissecting into the posterior cranial fossa and resulting in death is reported. The patient had undergone spinal puncture by the lateral cervical technique prior to development of the hematoma. Autopsy demonstrated that the source of hemorrhage was an anomalous intraspinal vertebral artery.

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Address reprint requests to: Larry A. Rogers, M.D., Charlotte Neurosurgical Associates, 1012 Kings Drive, Suite 101, Charlotte, North Carolina 28283.

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    Sketches demonstrating variation in the relationship of the vertebral arteries to the upper cervical spinal canal. A: “Normal” relationship, lateral (upper) and frontal (lower) projections. B: Representation of the vertebral artery duplication described by Kowada, et al.1,2 C: The intraspinal artery in the present case is presumed to be a variation of the anomaly shown in B, with only a vestigial extraspinal segment.

References

  • 1.

    Kowada MTakahashi MGito Yet al: Fenestration of the vertebral artery: report of two cases demonstrated by angiography. Neuroradiology 6:1101121973Kowada M Takahashi M Gito Y et al: Fenestration of the vertebral artery: report of two cases demonstrated by angiography. Neuroradiology 6:110–112 1973

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  • 2.

    Kowada MYamaguchi KTakahashi H: Fenestration of the vertebral artery with a review of 23 cases in Japan. Radiology 103:3433461972Kowada M Yamaguchi K Takahashi H: Fenestration of the vertebral artery with a review of 23 cases in Japan. Radiology 103:343–346 1972

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