A rare case of postpartum paraplegia due to spinal intradural hematoma.

Background: Spinal intradural hematomas rarely occur following spinal anesthesia. In this case, a 34-year-old postpartum female developed conus-cauda paraplegia (T12/L1-L5) due to an acute subdural hematoma after spinal anesthesia.

Case description: Four-day postpartum, a 34-year-old female presented with severe paraplegia (1/5 motor power), complete T12-L1 sensory loss, and bowel incontinence. The lumbar magnetic resonance imaging (MRI) revealed a subacute subdural hematoma extending from the L1 to L5 levels. An urgent L1-L5 laminectomy was performed for clot evacuation. Within 3 postoperative months, she regained 4+/5 motor strength bilaterally and full bowel/bladder control.

Conclusion: Spinal anesthesia may cause acute/subacute subdural hematomas. Here, 4-day postpartum, a 34-year-old female became paraplegic due to a subacute T12-L5 subdural hematoma documented on an MRI scan. She underwent emergent decompression, and within 3 postoperative months, regained nearly normal function.