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Respiratory Arrest and Cervical Spinal Cord Infarction Following Lumbar Puncture in Meningitis

Published online by Cambridge University Press:  18 September 2015

Margaret G. Norman*
Affiliation:
the Department of Pathology, Vancouver General Hospital and University of British Columbia, Vancouver, B.C
*
Children’s Hospital, 4480 Oak Street, Vancouver, B.C. V6H3V4
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A 6-year-old child with meningitis had a respiratory arrest 20 minutes after a lumbar puncture. Thereafter she required maintenance on a ventilator, had a flaccid quadriplegia, and died 12 days later. Necropsy showed infarction of the central portion of the cord at the level of the decussation of the pyramids. The suggested mechanism of damage is compression of the arterial supply to the cord at the level of the foramen magnum by herniated cerebellar tonsils; concomitant hypotension may have contributed to production of the damage. Four similar cases, who survived with residual deficit, have also been reported. Other separate mechanisms by which the cord can be damaged in meningitis are vasculitis, thrombosis and arachnoiditis.

Type
Research Article
Copyright
Copyright © Canadian Neurological Sciences Federation 1982

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