Lumbar puncture resulting in lumbar artery perforation and hypotension: A case report

Lumbar puncture (LP) is a very common procedure that can rarely lead to complications such as headache or spinal hematoma. This report presents the case of a 59-year-old female who underwent LP and subsequently developed a retroperitoneal hematoma leading to hemorrhagic shock, requiring emergent embolization by interventional radiology. Life-threatening bleeding is a very rare complication of LP but should be kept in mind especially for patients with large body habitus who undergo multiple unsuccessful bedside attempts. In this case, the LP needle missed the spinal canal and pierced the L4 lumbar artery. We present this case to uncover potential factors that may have contributed to the development of such hemorrhage and to elaborate the steps of care to control such devastating hemorrhage.