Abstract：
BACKGROUND:Lumbar puncture is a common procedure that can be safely performed in most patients. Certain populations may have increased risk for complications following lumbar puncture, but the significance of basilar invagination is often underappreciated. CASE DESCRIPTION:A 45-year-old woman with basilar invagination received multiple lumbar punctures in the workup of acute meningitis. Preprocedural computed tomography was obtained. Following lumbar puncture, the patient developed locked-in syndrome. Magnetic resonance imaging obtained several days later demonstrated severe compression and infarction of the medulla and inferior cerebellum by the odontoid process and ectopic cerebellar tonsils. The patient was transferred but at this point, surgical decompression was not possible. She did not regain significant neurologic function. CONCLUSIONS:Basilar invagination is a risk factor for devastating neurologic complications following lumbar puncture. Awareness of this complication and prompt recognition of its occurrence may prevent future morbidity of lumbar puncture in patients with basilar invagination.
journal_name
World Neurosurgjournal_title
World neurosurgeryauthors
Chen JA,Driver J,Segar D,Bernstock JD,Gupta S,Gormley Wdoi
10.1016/j.wneu.2020.02.040subject
Has Abstractpub_date
2020-05-01 00:00:00pages
292-295eissn
1878-8750issn
1878-8769pii
S1878-8750(20)30315-6journal_volume
137pub_type
abstract：:Bow hunter's syndrome is due to vertebrobasilar insufficiency caused by rotational compression of the vertebral artery. We report a case in which an osteophyte compressed the left vertebral artery causing cerebellar stroke. The patient underwent successful resection of the osteophyte via anterior surgical approach and...
journal_title：World neurosurgery
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