[Diffuse idiopathic skeletal hyperostosis, Forestier and Rotés-Querol syndrome, and difficult spinal puncture].
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A 53 year old male underwent total excision of a large sphenoidal wing meningioma. Patient was treated with cephalosporins and phenytoin for postoperative meningitis. Three weeks after surgery, a follow up lumbar puncture was done. The patient became paraplegic over a few hours. Imaging of the dorsolumbar spine and other investigations demonstrated a large intraspinal hematoma caused by thrombocytopenia which was probably drug induced. After normalising the platelet count surgical evacuation of the spinal subarachnoid hematoma was done. Relevant literature is reviewed.
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Lumbar puncture is frequently used for diagnostic and therapeutic purposes in children. Theoretically, this group of patients should have high rates of post lumbar puncture headache. However, the scant available literature points to a surprisingly low incidence and an apparently mild course. We present a 7 year-old patient with a severe post lumbar puncture headache successfully treated with an epidural blood patch. To our knowledge, this has not been reported in children younger than 10 years. We believe this procedure should be considered in pediatric patients with post lumbar puncture headache.
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