In patients with normal pressure hydrocephalus (NPH), lumbar puncture (LP) is an effective method for assessing both the diagnosis as well as the possible efficacy of ventriculoperitoneal shunting based on symptom improvement. However, it should be considered that there exists a low risk of complications and that these risks may result in morbidity and mortality. We present a patient who developed hematoma in the basal ganglia following LP.
A 56-year-old man presented with progressive dementia, ataxia, and urinary incontinence for 8 months. The patient received LP. He had no history of coagulopathy and had NPH findings on cranial magnetic resonance imaging. On the second day after LP, he complained of headache and had left hemiparesis, and intracerebral hematoma was observed at the basal ganglia, posterior to the lentiform nucleus.
Although intracerebral hematoma after LP is one of the rare complications to be more cautious about, particularly in patients with a history of chronic disease or chronic changes in imaging, a history of previous cerebrovascular events and recurrent LPs with probably less cerebrospinal fluid drainage should be planned. Moreover, it should be considered that intracerebral hematoma may develop in patients with clinical deterioration, and good clinical follow-up is required.
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