In this Danish cohort study, risk of spinal hematoma following lumbar puncture was 0.20% among patients without coagulopathy and 0.23% among those with coagulopathy. Strictly speaking, this is not a true hydrocephalus, but rather, a hydrocephalus look-alike condition. In these cases, brain tissues around the ventricles shrink, and the ventricles are bigger than normal because of this. Obstructive hydrocephalus in patient who declines, or is not a candidate for. Hydrocephalus ex-vacuo results from brain damage caused by stroke or injury. Risks did not increase significantly according to overall severity of coagulopathy, in subgroup analyses of severity of coagulopathy by pediatric specialty or medical indication (infection, neurological condition, and hematological malignancy), nor by cumulative number of procedures. Independent risk factors for spinal hematoma were male sex (adjusted hazard ratio, 1.72 95% CI, 1.15-2.56), those aged 41 through 60 years (adjusted HR, 1.96 95% CI, 1.01-3.81) and those aged 61 through 80 years (adjusted HR, 2.20 95% CI, 1.12-4.33). Follow-up was complete for more than 99% of the study participants. Thrombocytopenia was present in 7875 patients (9%), high INR levels in 1393 (2%), and prolonged APTT in 2604 (3%). Results: A total of 83 711 individual lumbar punctures were identified among 64 730 persons (51% female median age, 43 years ) at the time of the procedure. Adjusted hazard rate ratios (HRs) were computed using Cox regression models. Secondary analyses included risks of traumatic lumbar puncture (>300 × 106 erythrocytes/L after excluding patients diagnosed with subarachnoid hemorrhage). Risks were provided as numbers and percentages with 95% CIs. ![]() Main outcomes and measures: Thirty-day risk of spinal hematoma. Coagulopathy was defined as platelets lower than 150 × 109/L, international normalized ratio (INR) greater than 1.4, or activated partial thromboplastin time (APTT) longer than 39 seconds.Įxposures: Coagulopathy at the time of lumbar puncture. Danish nationwide, population-based cohort study using medical registries to identify persons who underwent lumbar puncture and had cerebrospinal fluid analysis (January 1, 2008-Decemfollowed up through October 30, 2019).
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