Be aware of the tuft of hair: traumatic lumbar intradural hematoma following spinal anesthesia in a case of occult spinal dysraphism. Illustrative case
- 1Department of Neurosurgery, Jawaharlal Nehru Medical College, KAHER University and KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Nehru Nagar, Belagavi, Karnataka, India
Abstract
BACKGROUND: Spinal intradural hematoma is a rare but potentially devastating complication of spinal anesthesia. Known risk factors include anticoagulation, coagulopathies, spinal trauma, tumors, infections, and congenital spinal anomalies.
OBSERVATIONS: The authors report the case of a 27-year-old postpartum female who developed acute bilateral lower limb weakness 3 days post–cesarean section under spinal anesthesia. On examination, she had a tuft of hair in the midline of the low back. MRI of the whole spine revealed a lumbosacral intradural hematoma with incidental findings of spinal dysraphism—diastematomyelia and tethering of the spinal cord. Emergency surgical evacuation was performed, but the patient was left with persistent neurological deficits.
LESSONS: This case underscores the importance of maintaining a high index of suspicion and performing a thorough preanesthetic spinal evaluation when cutaneous stigmata suggestive of occult spinal dysraphism are present.
https://thejns.org/doi/10.3171/CASE26343
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BibTeX
@article{patil2026aware,
title = {{Be aware of the tuft of hair: traumatic lumbar intradural hematoma following spinal anesthesia in a case of occult spinal dysraphism. Illustrative case}},
author = {Abhishek Patil and Vinayak Pillai},
journal = {Journal of Neurosurgery: Case Lessons},
year = {2026},
month = oct,
doi = {10.3171/case26343},
url = {https://doi.org/10.3171/case26343},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Be aware of the tuft of hair: traumatic lumbar intradural hematoma following spinal anesthesia in a case of occult spinal dysraphism. Illustrative case
AU - Abhishek Patil
AU - Vinayak Pillai
PY - 2026
DA - 2026/10/26
JO - Journal of Neurosurgery: Case Lessons
DO - 10.3171/case26343
UR - https://doi.org/10.3171/case26343
AB - BACKGROUND: Spinal intradural hematoma is a rare but potentially devastating complication of spinal anesthesia. Known risk factors include anticoagulation, coagulopathies, spinal trauma, tumors, infections, and congenital spinal anomalies. OBSERVATIONS: The authors report the case of a 27-year-old postpartum female who developed acute bilateral lower limb weakness 3 days post–cesarean section under spinal anesthesia. On examination, she had a tuft of hair in the midline of the low back. MRI of the whole spine revealed a lumbosacral intradural hematoma with incidental findings of spinal dysraphism—diastematomyelia and tethering of the spinal cord. Emergency surgical evacuation was performed, but the patient was left with persistent neurological deficits. LESSONS: This case underscores the importance of maintaining a high index of suspicion and performing a thorough preanesthetic spinal evaluation when cutaneous stigmata suggestive of occult spinal dysraphism are present. https://thejns.org/doi/10.3171/CASE26343
SN - 2694-1902
ER -