Spinal and cerebral hematoma following diagnostic lumbar puncture with fatal course

: A 64-year-old man suspected of having neurosyphillis suffered subarachnoid spinal and cerebral ventricular hemorrhage after a diagnostic lumbar puncture. The main risk factor was trauma occurring during a difficult puncture. Both the diagnosis and the subsequent laminectomy were delayed. Blood migrated to both lateral ventricles, complicating the clinical course, which ended in death. The need for rapid diagnosis and treatment in such cases is revealed by both images and clinical course. A pathophysiologic explanation for these hemorrhagic events is provided.