To the Editor.—
Caroscio and colleagues1 recently emphasized the occurrence of intracranial signs and symptoms in patients with spinal subarachnoid hemorrhage. If the spinal hemorrhage results in a focal hematoma, then there may be spinal cord compression and only local meningeal signs. At the New York Hospital, I have found seven cases of extra parenchymal spinal hematoma in 342 patients who were anticoagulated after lumbar puncture, two of whom had spinal subarachnoid hematomas. The patients with spinal subarachnoid hematomas had lumbosacral back pain and paraplegia, but they did not have meningismus or other meningeal signs. Others have noted that spinal subarachnoid hemorrhage may produce spinal cord compression,2.3 and that lumbar puncture and anticoagulation increase the risk of spinal subarachnoid hematoma.2-5
Ruff RL. Cord Compression From Spinal Subarachnoid Hemorrhage. Arch Neurol. 1980;37(7):467. doi:10.1001/archneur.1980.00500560097023
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