Bloody Taps 2000 update

Sunday, 20 February 2005 15:33
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Bloody taps:

A further danger of spinal injections is that of local trauma to neural tissue and bleeding into the subarachnoid space. The dangers of the former related to direct trauma caused by the injecting needle, possibly to nerve roots; the latter refers to the highly irritant effect of blood in the subarachnoid space: which of itself is sufficient to cause long-term adverse effects such as arachnoiditis. In 1928, Bagley studied the effect of a few millilitres of blood injected into the spinal fluid, in both dogs and human subjects. He found that this caused a considerable meningeal reaction, which subsided in most cases, but persisted in a few, leading on to fibrosis (scarring).

Aldrete clearly states that blood-tinged CSF noted at the time of spinal puncture, should "merit close follow-up of the patient, since they have the potential for producing ARC (arachnoiditis) by the mere presence of blood in the intrathecal compartment." In punctures at thoracic or cervical levels there is risk of traumatic damage to the spinal cord as well as nerve roots.