array:22 [
  "pii" => "S1130147305703936"
  "issn" => "11301473"
  "doi" => "10.1016/S1130-1473(05)70393-6"
  "estado" => "S300"
  "fechaPublicacion" => "2005-01-01"
  "aid" => "70393"
  "copyright" => "Sociedad Española de Neurocirugía"
  "copyrightAnyo" => "2005"
  "documento" => "article"
  "crossmark" => 0
  "subdocumento" => "fla"
  "cita" => "Neurocirugia. 2005;16:447-52"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:2 [
    "total" => 1859
    "formatos" => array:3 [
      "EPUB" => 15
      "HTML" => 1242
      "PDF" => 602
    ]
  ]
  "itemAnterior" => array:18 [
    "pii" => "S1130147305703924"
    "issn" => "11301473"
    "doi" => "10.1016/S1130-1473(05)70392-4"
    "estado" => "S300"
    "fechaPublicacion" => "2005-01-01"
    "aid" => "70392"
    "copyright" => "Sociedad Española de Neurocirugía"
    "documento" => "article"
    "crossmark" => 0
    "subdocumento" => "fla"
    "cita" => "Neurocirugia. 2005;16:441-6"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 2397
      "formatos" => array:3 [
        "EPUB" => 14
        "HTML" => 1350
        "PDF" => 1033
      ]
    ]
    "es" => array:10 [
      "idiomaDefecto" => true
      "titulo" => "Anatomía topográfica del asterion"
      "tienePdf" => "es"
      "tieneTextoCompleto" => 0
      "tieneResumen" => array:2 [
        0 => "es"
        1 => "en"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "441"
          "paginaFinal" => "446"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Topographyc anatomy of the asterion"
        ]
      ]
      "contieneResumen" => array:2 [
        "es" => true
        "en" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "F. Martínez, A. Laxague, L. Vida, H. Prinzo, N. Sgarbi, V.R. Soria, C. Bianchí"
          "autores" => array:7 [
            0 => array:2 [
              "nombre" => "F."
              "apellidos" => "Martínez"
            ]
            1 => array:2 [
              "nombre" => "A."
              "apellidos" => "Laxague"
            ]
            2 => array:2 [
              "nombre" => "L."
              "apellidos" => "Vida"
            ]
            3 => array:2 [
              "nombre" => "H."
              "apellidos" => "Prinzo"
            ]
            4 => array:2 [
              "nombre" => "N."
              "apellidos" => "Sgarbi"
            ]
            5 => array:2 [
              "nombre" => "V.R."
              "apellidos" => "Soria"
            ]
            6 => array:2 [
              "nombre" => "C."
              "apellidos" => "Bianchí"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1130147305703924?idApp=UINPBA00004B"
    "url" => "/11301473/0000001600000005/v1_201305151245/S1130147305703924/v1_201305151245/es/main.assets"
  ]
  "es" => array:15 [
    "idiomaDefecto" => true
    "titulo" => "Hematoma subaracnoideo espinal tras punción lumbar en paciente con leucemia. Presentación de un caso y revisión de la literatura"
    "tieneTextoCompleto" => 0
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "447"
        "paginaFinal" => "452"
      ]
    ]
    "autores" => array:2 [
      0 => array:4 [
        "autoresLista" => "J. Ayerbe, P. Sousa"
        "autores" => array:2 [
          0 => array:3 [
            "nombre" => "J."
            "apellidos" => "Ayerbe"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">¿</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:2 [
            "nombre" => "P&#46;"
            "apellidos" => "Sousa"
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Servicios de Neurocirug&#237;a&#46; Fundaci&#243;n Jim&#233;nez D&#237;az&#46; Madrid"
            "identificador" => "aff0005"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Correspondencia postal&#58; Servicio de Neurocirug&#237;a&#46; Fundaci&#243;n &#8220;Jim&#233;nez D&#237;az&#8221;&#46; Avda&#46; Reyes Cat&#243;licos&#44; 2&#46; 28040 Madrid&#46;"
          ]
        ]
      ]
      1 => array:3 [
        "autoresLista" => "D&#46; Qui&#241;ones, E&#46; Prieto"
        "autores" => array:2 [
          0 => array:3 [
            "nombre" => "D&#46;"
            "apellidos" => "Qui&#241;ones"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "E&#46;"
            "apellidos" => "Prieto"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;&#42;</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:2 [
          0 => array:3 [
            "entidad" => "Servicios de Neurorradiolog&#237;a&#46; Fundaci&#243;n Jim&#233;nez D&#237;az&#46; Madrid"
            "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
            "identificador" => "aff0010"
          ]
          1 => array:3 [
            "entidad" => "Servicios de Hematolog&#237;a&#46; Fundaci&#243;n Jim&#233;nez D&#237;az&#46; Madrid"
            "etiqueta" => "<span class="elsevierStyleSup">&#42;&#42;</span>"
            "identificador" => "aff0015"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "en" => array:1 [
        "titulo" => "Spinal subarachnoid hematoma after lumbar puncture in a patient with leukemia&#46; Report of a case and review of the literature"
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2004-11-15"
    "fechaAceptado" => "2004-12-03"
    "PalabrasClave" => array:2 [
      "es" => array:2 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec159056"
          "palabras" => array:2 [
            0 => "Hematoma subaracnoideo espinal"
            1 => "Punci&#243;n lumbar"
          ]
        ]
        1 => array:4 [
          "clase" => "abr"
          "titulo" => "Abreviaturas"
          "identificador" => "xpalclavsec159054"
          "palabras" => array:4 [
            0 => "HSAE"
            1 => "LP"
            2 => "PL"
            3 => "SSAH"
          ]
        ]
      ]
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Key words"
          "identificador" => "xpalclavsec159055"
          "palabras" => array:2 [
            0 => "Spinal subarachnoid hematoma"
            1 => "Lumbar puncture"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "es" => array:2 [
        "titulo" => "Resumen"
        "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">La compresi&#243;n mielo-radicular aguda secundaria a un hematoma subaracnoideo espinal &#40;HSAE&#41; es una complicaci&#243;n extremadamente rara tras una punci&#243;n lumbar &#40;PL&#41;&#46; En el mecanismo de producci&#243;n de estos hematomas han sido implicados diversos factores de riesgo&#44; principalmente la presencia de trastornos de la hemostasia en el paciente&#46;</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Presentamos el caso de un var&#243;n de 20 a&#241;os con leucemia aguda y trombocitopenia &#40;26&#46;000 plaquetas&#47;mm<span class="elsevierStyleSup">3</span>&#41; que&#44; tras ser sometido a una PL&#44; desarroll&#243; una paraparesia con imposibilidad para la bipedestaci&#243;n&#46; La resonancia magn&#233;tica &#40;RM&#41; demostr&#243; la presencia de un hematoma intradural ventral desde D12 hasta L4&#46; Se realiz&#243; una laminectom&#237;a descompresiva de urgencia y se pudo evacuar parcialmente un hematoma localizado en el espacio subaracnoideo&#46; Al cuarto d&#237;a postoperatorio&#44; el paciente consigui&#243; caminar sin ayuda&#44; pero falleci&#243; un mes despu&#233;s debido a complicaciones sist&#233;micas de su enfermedad&#46;</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">S&#243;lo se han encontrado 26 casos de HSAE tras PL en la revisi&#243;n de la literatura que hemos realizado&#46; Se han observado las siguientes caracter&#237;sticas comunes a la mayor&#237;a de ellos&#58; asociaci&#243;n con tratamientos anticoagulantes&#44; asociaci&#243;n con trombocitopenia&#44; aparici&#243;n de s&#237;ndrome compresivo mielo-radicular de forma retardada&#44; necesidad de tratamiento quir&#250;rgico&#44; buen resultado funcional en la mitad de los pacientes&#44; y corta esperanza de vida en aquellos con enfermedad previa grave&#46; En pacientes leuc&#233;micos con tendencia a tener marcada trombocitopenia &#40;quiz&#225;s por debajo de 25&#46;000 plaquetas&#47;mm<span class="elsevierStyleSup">s</span>&#41;&#44; el riesgo de desarrollar un HSAE tras PL puede ser elevado&#46;</p>"
      ]
      "en" => array:2 [
        "titulo" => "Summary"
        "resumen" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Acute myeloradicular compression due to a spinal subarachnoid hematoma &#40;SSAH&#41; after lumbar puncture &#40;LP&#41; is an extremely rare complication&#46; Several risk factors have been involved in the production of these hematomas&#44; mainly the presence of hemostasis disorders in the patient&#46;</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">We report the case of a 20-year-old man with leukemia and thrombocytopenia &#40;26&#46;000 platelets&#47;mm<span class="elsevierStyleSup">3</span>&#41; who&#44; after undergoing a LP&#44; developed paraparesis and became unable to stand&#46; A magnetic resonance disclosed the presence of a ventral intradural hematoma from D12 to L4&#46; An emergency decompressive laminectomy was performed and an hematoma located in the subarachnoid space was partially removed&#46; On the fourth postoperative day&#44; the patient was able to walk without assistance&#44; but one month later&#44; he died because of systemic complications of his disease&#46;</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Only 26 cases of SSAH after LP have been found in the literature review we have performed&#46; In most of them&#44; the following common features have been observed&#58; association with anticoagulant therapies&#44; association with thrombocytopenia&#44; delayed onset of compressive myeloradicular syndrome&#44; need of surgical treatment&#44; good functional outcome in half of patients&#44; and short life expectancy for patients with previous serious illness&#46; Risk for developing a SSAH after LP could be high in leukemia patients with a tendency to have severe thrombocytopenia &#40;perhaps less than 25&#46;000 platelets&#47;mm<span class="elsevierStyleSup">3</span>&#41;&#46;</p>"
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara">Ayerbe&#44; J&#46;&#59; Qui&#241;ones&#44; D&#46;&#59; Prieto&#44; E&#46;&#59; Sousa&#44; P&#46;&#58; Hematoma subaracnoideo espinal tras punci&#243;n lumbar en paciente con leucemia&#46; Presentaci&#243;n de un caso y revisi&#243;n de la literarura&#46; Neurocirug&#237;a 2005&#59; 16&#58; 447&#8211;452&#46;</p>"
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "Bibliograf&#237;a"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:21 [
            0 => array:3 [
              "identificador" => "bib1"
              "etiqueta" => "1&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Acute hemor-rhagic complication of diagnostic lumbar puncture"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46;D&#46; Adler"
                            1 => "A&#46;E&#46; Comi"
                            2 => "A&#46;R&#46; Walker"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatr Emerg Care"
                        "fecha" => "2001"
                        "volumen" => "17"
                        "paginaInicial" => "184"
                        "paginaFinal" => "188"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11437143"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib2"
              "etiqueta" => "2&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "CT demonstration of a spinal subarachnoid haematoma following lumbar puncture"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "E&#46;A&#46; Bellamy"
                            1 => "D&#46;J&#46; P&#233;rez"
                            2 => "E&#46; Husband"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "J Comput Assist Tomogr"
                        "fecha" => "1984"
                        "paginaInicial" => "791"
                        "paginaFinal" => "792"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib3"
              "etiqueta" => "3&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Spinal subarachnoid hematoma after lumbar puncture causing reversible paraplegia in acute leukemia&#46; Case report"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "J&#46; Blad&#233;"
                            1 => "F&#46; Gast&#243;n"
                            2 => "E&#46; Montserrat"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.1983.58.3.0438"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "1983"
                        "volumen" => "58"
                        "paginaInicial" => "438"
                        "paginaFinal" => "439"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6572224"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib4"
              "etiqueta" => "4&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Radicular vessels are the most probable source of needle-induced blood in lumbar puncture"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46;C&#46; Breuer"
                            1 => "H&#46;R&#46; Tyler"
                            2 => "D&#46;I&#46; Marzewski"
                            3 => "D&#46;S&#46; Rosenthal"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Cancer"
                        "fecha" => "1982"
                        "volumen" => "49"
                        "paginaInicial" => "2168"
                        "paginaFinal" => "2172"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7074532"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib5"
              "etiqueta" => "5&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Seguimiento con resonancia magn&#233;tica de un hematoma medular subaracnoideo ventral espont&#225;neo"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "A&#46; Cabrera"
                            1 => "l&#46; Manchola"
                            2 => "J&#46;A&#46; Larena"
                            3 => "B&#46; Mart&#237;nez de Guere&#241;u"
                            4 => "O&#46; Casado"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Neurol"
                        "fecha" => "2001"
                        "volumen" => "32"
                        "paginaInicial" => "1137"
                        "paginaFinal" => "1140"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11562845"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib6"
              "etiqueta" => "6&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Hematomas raqu&#237;deos con compresi&#243;n medular relacionados con las anestesias neuroaxiales en Espa&#241;a"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "J&#46; Castillo"
                            1 => "X&#46; Santiveri"
                            2 => "J&#46; Escolano"
                            3 => "J&#46; Casta&#241;o"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Esp Anestesiol Reanim"
                        "fecha" => "2003"
                        "volumen" => "50"
                        "paginaInicial" => "504"
                        "paginaFinal" => "509"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14737776"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib7"
              "etiqueta" => "7&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Nontraumatic acute spinal subdural hematoma&#58; report of five cases and review of the literature"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46; Domenicucci"
                            1 => "A&#46; Ramieri"
                            2 => "P&#46; Ciappetta"
                            3 => "R&#46; Delfini"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Neurosurg Spine"
                        "fecha" => "1999"
                        "volumen" => "91"
                        "paginaInicial" => "65"
                        "paginaFinal" => "73"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib8"
              "etiqueta" => "8&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Spinal subdural hematoma complicating lumbar puncture&#58; ocurrence in thrombocytopenic patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "R&#46;N&#46; Edelson"
                            1 => "N&#46;L&#46; Chernik"
                            2 => "J&#46;B&#46; Posner"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Neurol"
                        "fecha" => "1974"
                        "volumen" => "31"
                        "paginaInicial" => "134"
                        "paginaFinal" => "137"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/4525944"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib9"
              "etiqueta" => "9&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Spinal subarachnoid hematoma following lumbar puncture"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46; Goyal"
                            1 => "R&#46; Dua"
                            2 => "D&#46; Singh"
                            3 => "S&#46; Kumar"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurol India"
                        "fecha" => "1999"
                        "volumen" => "47"
                        "paginaInicial" => "339"
                        "paginaFinal" => "340"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10625917"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib10"
              "etiqueta" => "10&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Coagulopathy induced spinal intradural extramedullary haematoma&#58; report of three cases and review of the literature"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "O&#46; Hausmann"
                            1 => "E&#46; Kirsch"
                            2 => "E&#46; Rad&#252;"
                            3 => "Th&#46; Mindermann"
                            4 => "O&#46; Gratzl"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Acta Neurochir"
                        "fecha" => "2001"
                        "volumen" => "143"
                        "paginaInicial" => "135"
                        "paginaFinal" => "140"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11459084"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib11"
              "etiqueta" => "11&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Idiopathic spontaneous spinal subarachnoid hemorrhage"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "Y&#46;H&#46; Kim"
                            1 => "K&#46;T&#46; Cho"
                            2 => "C&#46;K&#46; Chung"
                            3 => "H&#46;J&#46; Kim"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1038/sj.sc.3101620"
                      "Revista" => array:6 [
                        "tituloSerie" => "Spinal Cord"
                        "fecha" => "2004"
                        "volumen" => "42"
                        "paginaInicial" => "545"
                        "paginaFinal" => "547"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15111997"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib12"
              "etiqueta" => "12&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Spontaneous spinal subarachnoid hematoma of unknown pathogenesis&#58; case reports"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46; Komiyama"
                            1 => "T&#46; Yasui"
                            2 => "T&#46; Sumimoto"
                            3 => "Y&#46; Fu"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurosurgery"
                        "fecha" => "1997"
                        "volumen" => "41"
                        "paginaInicial" => "691"
                        "paginaFinal" => "694"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9310992"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib13"
              "etiqueta" => "13&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Spinal hematoma&#58; a literature survey with metaanalysis of 613 patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "D&#46; Kreppel"
                            1 => "G&#46; Antoniadis"
                            2 => "W&#46; Seeling"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s10143-002-0224-y"
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurosurg Rev"
                        "fecha" => "2003"
                        "volumen" => "26"
                        "paginaInicial" => "1"
                        "paginaFinal" => "49"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12520314"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib14"
              "etiqueta" => "14&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Serial magnetic resonance imaging findings for a spontaneously resolving spinal subdural hematoma&#58; case report"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46;V&#46; Kulkarni"
                            1 => "R&#46;A&#46; Willinsky"
                            2 => "T&#46; Gray"
                            3 => "M&#46; Cusimano"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurosurgery"
                        "fecha" => "1998"
                        "volumen" => "42"
                        "paginaInicial" => "398"
                        "paginaFinal" => "400"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9482194"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib15"
              "etiqueta" => "15&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Spinal subarachnoid hematomas&#58; clue to a source of bleeding in traumatic lumbar puncture"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46;C&#46; Masdeu"
                            1 => "A&#46;C&#46; Breuer"
                            2 => "W&#46;C&#46; Schoene"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurology"
                        "fecha" => "1979"
                        "volumen" => "29"
                        "paginaInicial" => "872"
                        "paginaFinal" => "876"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/572011"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib16"
              "etiqueta" => "16&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Post lumbar puncture spinal subarachnoid hematoma causing paraplegia&#58; a short report"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "S&#46;B&#46; Pai"
                            1 => "K&#46;N&#46; Krishna"
                            2 => "S&#46; Chandrashekar"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurol India"
                        "fecha" => "2002"
                        "volumen" => "50"
                        "paginaInicial" => "367"
                        "paginaFinal" => "369"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12391473"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib17"
              "etiqueta" => "17&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Chronic subdural hematoma of the spinal cord&#58; report of a case"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "J&#46; Rader"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJM195509012530906"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "1955"
                        "volumen" => "253"
                        "paginaInicial" => "374"
                        "paginaFinal" => "376"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/13244833"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib18"
              "etiqueta" => "18&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Spinal subarachnoid bleeding of unknown etiology&#46; Case repots"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46; Ruelle"
                            1 => "D&#46; Zerbi"
                            2 => "G&#46; Andrioli"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg Sci"
                        "fecha" => "2001"
                        "volumen" => "45"
                        "paginaInicial" => "53"
                        "paginaFinal" => "57"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11466509"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib19"
              "etiqueta" => "19&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Acute spinal intradural extramedullary hematoma&#58; a nonsurgical approach for spinal cord decompression"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "K&#46; Schwerdtfeger"
                            1 => "W&#46; Caspar"
                            2 => "S&#46; Alloussi"
                            3 => "M&#46; Strowitzki"
                            4 => "F&#46; Loew"
                            5 => "&#58;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurosurgery"
                        "fecha" => "1990"
                        "volumen" => "27"
                        "paginaInicial" => "312"
                        "paginaFinal" => "314"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2385352"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib20"
              "etiqueta" => "20&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Spinal subarachnoid hematoma complicating lumbar puncture&#58; diagnosis and management"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "E&#46;W&#46; Scott"
                            1 => "C&#46;R&#46; Cazenave"
                            2 => "C&#46; Virapongse"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurosurgery"
                        "fecha" => "1989"
                        "volumen" => "25"
                        "paginaInicial" => "287"
                        "paginaFinal" => "293"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2770992"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib21"
              "etiqueta" => "21&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Paraparesis after lumbar puncture in a male with leukemia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "P&#46;W&#46; Wirtz"
                            1 => "B&#46;R&#46; Bloem"
                            2 => "F&#46;J&#46;M&#46; van der Meer"
                            3 => "O&#46;F&#46; Brouwer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatr Neurol"
                        "fecha" => "2000"
                        "volumen" => "23"
                        "paginaInicial" => "67"
                        "paginaFinal" => "68"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10963974"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "es"
  "url" => "/11301473/0000001600000005/v1_201305151245/S1130147305703936/v1_201305151245/es/main.assets"
  "Apartado" => null
  "PDF" => "https://static.elsevier.es/multimedia/11301473/0000001600000005/v1_201305151245/S1130147305703936/v1_201305151245/es/main.pdf?idApp=UINPBA00004B&text.app=https://revistaneurocirugia.com/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1130147305703936?idApp=UINPBA00004B"
]
Compartir
Información de la revista
Vol. 16. Núm. 5.
Páginas 447-452 (enero 2004)
Compartir
Compartir
Descargar PDF
Más opciones de artículo
Vol. 16. Núm. 5.
Páginas 447-452 (enero 2004)
Hematoma subaracnoideo espinal tras punción lumbar en paciente con leucemia. Presentación de un caso y revisión de la literatura
Spinal subarachnoid hematoma after lumbar puncture in a patient with leukemia. Report of a case and review of the literature
Visitas
1848
J. Ayerbe
, P. Sousa
Servicios de Neurocirugía. Fundación Jiménez Díaz. Madrid
D. Quiñones*, E. Prieto**
* Servicios de Neurorradiología. Fundación Jiménez Díaz. Madrid
** Servicios de Hematología. Fundación Jiménez Díaz. Madrid
Este artículo ha recibido
Información del artículo
Resumen
Bibliografía
Descargar PDF
Estadísticas
Resumen

La compresión mielo-radicular aguda secundaria a un hematoma subaracnoideo espinal (HSAE) es una complicación extremadamente rara tras una punción lumbar (PL). En el mecanismo de producción de estos hematomas han sido implicados diversos factores de riesgo, principalmente la presencia de trastornos de la hemostasia en el paciente.

Presentamos el caso de un varón de 20 años con leucemia aguda y trombocitopenia (26.000 plaquetas/mm3) que, tras ser sometido a una PL, desarrolló una paraparesia con imposibilidad para la bipedestación. La resonancia magnética (RM) demostró la presencia de un hematoma intradural ventral desde D12 hasta L4. Se realizó una laminectomía descompresiva de urgencia y se pudo evacuar parcialmente un hematoma localizado en el espacio subaracnoideo. Al cuarto día postoperatorio, el paciente consiguió caminar sin ayuda, pero falleció un mes después debido a complicaciones sistémicas de su enfermedad.

Sólo se han encontrado 26 casos de HSAE tras PL en la revisión de la literatura que hemos realizado. Se han observado las siguientes características comunes a la mayoría de ellos: asociación con tratamientos anticoagulantes, asociación con trombocitopenia, aparición de síndrome compresivo mielo-radicular de forma retardada, necesidad de tratamiento quirúrgico, buen resultado funcional en la mitad de los pacientes, y corta esperanza de vida en aquellos con enfermedad previa grave. En pacientes leucémicos con tendencia a tener marcada trombocitopenia (quizás por debajo de 25.000 plaquetas/mms), el riesgo de desarrollar un HSAE tras PL puede ser elevado.

Palabras clave:
Hematoma subaracnoideo espinal
Punción lumbar
Abreviaturas:
HSAE
LP
PL
SSAH
Summary

Acute myeloradicular compression due to a spinal subarachnoid hematoma (SSAH) after lumbar puncture (LP) is an extremely rare complication. Several risk factors have been involved in the production of these hematomas, mainly the presence of hemostasis disorders in the patient.

We report the case of a 20-year-old man with leukemia and thrombocytopenia (26.000 platelets/mm3) who, after undergoing a LP, developed paraparesis and became unable to stand. A magnetic resonance disclosed the presence of a ventral intradural hematoma from D12 to L4. An emergency decompressive laminectomy was performed and an hematoma located in the subarachnoid space was partially removed. On the fourth postoperative day, the patient was able to walk without assistance, but one month later, he died because of systemic complications of his disease.

Only 26 cases of SSAH after LP have been found in the literature review we have performed. In most of them, the following common features have been observed: association with anticoagulant therapies, association with thrombocytopenia, delayed onset of compressive myeloradicular syndrome, need of surgical treatment, good functional outcome in half of patients, and short life expectancy for patients with previous serious illness. Risk for developing a SSAH after LP could be high in leukemia patients with a tendency to have severe thrombocytopenia (perhaps less than 25.000 platelets/mm3).

Key words:
Spinal subarachnoid hematoma
Lumbar puncture

Artículo

Opciones para acceder a los textos completos de la publicación Neurocirugía
Socio
Socio de la Sociedad Española de Neurocirugía

Si es la primera vez que accede a la web puede obtener sus claves de acceso poniéndose en contacto con Elsevier España en suscripciones@elsevier.com o a través de su teléfono de Atención al Cliente 902 88 87 40 si llama desde territorio español o del +34 932 418 800 (de 9 a 18h., GMT + 1) si lo hace desde el extranjero.

Si ya tiene sus datos de acceso, clique aquí.

Si olvidó su clave de acceso puede recuperarla clicando aquí y seleccionando la opción "He olvidado mi contraseña".

Suscriptor
Suscriptor de la revista

Si ya tiene sus datos de acceso, clique aquí.

Si olvidó su clave de acceso puede recuperarla clicando aquí y seleccionando la opción "He olvidado mi contraseña".
Suscribirse
Suscribirse a:

Neurocirugía

Comprar
Comprar acceso al artículo

Comprando el artículo el PDF del mismo podrá ser descargado

Precio 19,34 €

Comprar ahora
Contactar
Teléfono para suscripciones e incidencias
De lunes a viernes de 9h a 18h (GMT+1) excepto los meses de julio y agosto que será de 9 a 15h
Llamadas desde España
932 415 960
Llamadas desde fuera de España
+34 932 415 960
Email
Idiomas
Neurocirugía
Opciones de artículo
Herramientas
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?