Combined subarachnoid and subdural spinal hematoma following spinal puncture.

A case of combined subarachnoid and subdural spinal hematomas secondary to lumbar puncture during myelography is described. Contributing factors to this particular syndrome are discussed and the separate clinical syndromes of epidural and subarachnoid spinal hematomas are described. The incidence of all spinal hematomas appears to be increasing, due to the combined factors of spinal trauma and anticoagulant therapy. Spinal hematomas typically present with severe and localized back pain, rapidly progressive myelopathy and a poor prognosis for functional recovery unless immediate decompression is performed.