Spinal Subarachnoid Hemorrhage Following Lumbar Puncture

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Abstract
In 1885, while experimenting with the action of cocaine on spinal nerves in a dog, J. Leonard Corning accidentally injected the solution into the subarachnoid space and produced the first recorded spinal anesthesia. In 1891, Quincke reported a standard technique for lumbar puncture in man. Seven years later, the first spinal anesthesia in man was recorded when August Bier, with the help of an assistant, injected 2 ml. of 1% cocaine solution into his own subarachnoid space. The era of popularity of spinal anesthesia that followed his initial report was soon dampened by frequent tragic results, which we now recognize were caused by the intentional use of high levels of anesthesia, the use of such toxic drugs as cocaine in large doses, and the failure to appreciate the effects of gravity on the anesthetic level (Trendelenberg position was routinely used for its effect on blood pressure). The discovery of less

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