INTRACRANIAL SUBDURAL HEMATOMA FOLLOWING HEMATOPOETIC STEM CELL TRANSPLANTATION FOR ACUTE LEUKEMIA

Intracranial subdural hematoma following lumbar puncture is attributed to turning and rupture of small veins during downward movement of the brain. We report two cases of intracranial subdural hematoma after lumbar puncture that developed after allogeneic hematopoetic stem cell transplantation for acute leukemia. Both patients had received intratechal chemotherapy as associated conditioning regimen and developed headache followed by neurological dysfunction. Diagnosis was made in the first patient by CT scan but in the second patient could only be made in MRI. Management included anti-edema therapy and anti-convulsive therapy that was followed eventually by evacuation of the hematom. We suggest that this complication should be considered in patients who have prolonged headache or who develop neurological signs after lumbar puncture.

Keywords: lumbar puncture, acute leukemia, transplantation, subdural hematoma