The subdural puncture is a simple procedure in which either a short 20-gauge spinal needle or preferably a blunt subdural needle is introduced into the subdural space at the lateral border of the anterior fontanel. The procedure is used for diagnostic and therapeutic purposes.
Complications are unusual. Matson1 mentioned the possibility of a fistula if repeated taps were performed in the same location. Gutin et al2 reported a cerebral convexity epidermoid tumor that occurred at the site of previous subdural taps. They thought that the tumor was the result of epidermis being carried on the needle and implanted at the time of the initial puncture. Other conceivable problems are meningitis or subdural empyema occurring after taps are done without proper attention to aseptic technique and seizures caused by penetration of the needle into the brain.3
We report a case in which an acute subdural hematoma, occurring after