Cerebral venous thrombosis after lumbar puncture and treatment with high-dose corticosteroids

Background. The association between cerebral venous thrombosis (CVT) and multiple sclerosis (MS) has already been reported in patients with clinically definite MS in relation to intravenous methylprednisolone (IVMP) or previously performed lumbar puncture (LP).Case Summery. We report a 29-year-old Indian female who presented with a clinically isolated spinal cord syndrome according to the revised 2010 McDonald Criteria. She developed CVT after a lumbar puncture and two days of finishing the course of IVMP.Conclusion. We conclude that the sequence of doing lumbar puncture followed by high-dose IVMP may increase the risk of CVT. A prophylactic anticoagulation may be indicated in this setting.

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Cerebral venous thrombosis and demyelinating diseases: report of a case in a clinically isolated syndrome suggestive of multiple sclerosis onset and review of the literature

Multiple Sclerosis Journal ◽

10.1191/1352458505ms1125cr ◽

2005 ◽

Vol 11 (2) ◽

pp. 242-244 ◽

Cited By ~ 14

Author(s):

Maurizia Maurelli ◽

Roberto Bergamaschi ◽

Elisa Candeloro ◽

Alessandra Todeschini ◽

Giuseppe Micieli

Keyword(s):

Multiple Sclerosis ◽

Venous Thrombosis ◽

Lumbar Puncture ◽

Cerebral Venous Thrombosis ◽

Corticosteroid Treatment ◽

Clinically Isolated Syndrome ◽

Demyelinating Diseases ◽

High Dose ◽

First Case ◽

Definite Multiple Sclerosis

Cerebral venous thrombosis (CVT) has been described in several cases of clinically definite multiple sclerosis (MS). In the majority of these, lumbar puncture followed by intravenous corticosteroid treatment was suspected as the cause. We report what is, to our knowledge, the first case of a patient with a multifocal clinically isolated syndrome suggestive of MS onset, who developed multiple CVT after lumbar puncture and during high-dose i.v. corticosteroid treatment. We conclude that the sequence ‘lumbar puncture followed by corticosteroid treatment’ may be a contributory risk factor for the development of CVT when associated with other risk factors.

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Cerebral venous thrombosis after lumbar puncture and intravenous high dose corticosteroids: A case report of a childhood multiple sclerosis

Brain and Development ◽

10.1016/j.braindev.2012.09.001 ◽

2013 ◽

Vol 35 (6) ◽

pp. 602-605 ◽

Cited By ~ 7

Author(s):

Anna Presicci ◽

Vincenza Garofoli ◽

Marta Simone ◽

Maria Gloria Campa ◽

Anna Linda Lamanna ◽

...

Keyword(s):

Multiple Sclerosis ◽

Case Report ◽

Venous Thrombosis ◽

Lumbar Puncture ◽

Cerebral Venous Thrombosis ◽

High Dose

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Cerebral venous thrombosis as a complication of intracranial hypotension after lumbar puncture

BMJ Neurology Open ◽

10.1136/bmjno-2020-000046 ◽

2020 ◽

Vol 2 (2) ◽

pp. e000046

Author(s):

Leon Stephen Edwards ◽

Ramesh Cuganesan ◽

Cecilia Cappelen-Smith

Keyword(s):

Iron Deficiency ◽

Optic Neuritis ◽

Venous Thrombosis ◽

Lumbar Puncture ◽

Cerebral Venous Thrombosis ◽

Intracranial Hypotension ◽

Iron Deficiency Anaemia ◽

Early Recognition ◽

Nerve Lesion ◽

Deficiency Anaemia

BackgroundOptic neuritis is recognised by the international classification of headache disorders as a painful cranial nerve lesion. A lumbar puncture may be performed in the investigation of optic neuritis. Postdural puncture headache (PDPH) due to intracranial hypotension is a frequent complication of this procedure. In contrast, cerebral venous thrombosis (CVT) is a rare but potentially fatal complication of dural puncture. A few studies have identified an association between iron deficiency anaemia and venous thrombosis. There are no reports linking CVT with lumbar puncture and iron deficiency anaemia.Methods and resultsWe present a 32-year-old woman with optic neuritis and iron deficiency anaemia complicated by a PDPH and CVT.ConclusionCVT should be considered in a patient with persistent headache, recent lumbar puncture and iron deficiency anaemia. Early recognition and treatment of this condition are vital to avoiding mortality and morbidity.

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