Substantial risk of cerebellomedullary cistern hemorrhage with traditional acupuncture: a case report and review of literature

Acupuncture is generally regarded as a safe procedure but is not without risk; serious and even life-threatening incidents have been repeatedly reported in both Chinese and English literature. The authors report a rare case of hemorrhage in the cisterna magna following acupuncture. A 60-year-old woman developed an acute frontal headache, dizziness, neck pain, neck stiffness, and paresthesia or tingling discomfort in the arms and legs immediately after an acupuncture treatment that had been performed to treat the patient's chronic posterior nuchal pain. Computerized tomography (CT) scans showed a 1.8 x 0.9 cm-sized hematoma with subarachnoid hemorrhage within the cisterna magna located posteriorly and towards the right side of the medulla oblongata. The blood refluxed diffusely to the cerebellomedullary cistern and the fourth ventricle, causing an obstructive hydrocephalus. It is probable that the acupuncture needle had been inserted too deeply into the cisterna magna and provoked a small hemorrhage in the cistern. She gradually recovered from this iatrogenic event after treatment and was discharged 20 days later.