Gupta Kaustubh, Raj Gaurav, Kumar Tushant, Sonkar Shailly
Department of Radio-diagnosis, Dr. RMLIMS, Lucknow, Uttar Pradesh, India.
Radiol Case Rep. 2025 Jun 16;20(9):4409-4412. doi: 10.1016/j.radcr.2025.05.067. eCollection 2025 Sep.
Spinal subdural hematomas following lumbar puncture are rare but serious complications, typically associated with coagulopathies. We report a case of a 27-year-old male who developed progressive lower limb weakness and urinary incontinence after undergoing a diagnostic lumbar puncture at an outside facility. MRI spine initially suggested an intradural neoplasm due to clumped nerve roots and abnormal signal, delaying diagnosis. Further evaluation revealed previously undiagnosed thrombocytopenia (platelet count <30,000). The patient was managed conservatively following platelet transfusion with eventual neurological improvement. This case highlights the critical need for preprocedural coagulation screening and the diagnostic challenges posed by atypical imaging presentations of spinal hematoma.
腰椎穿刺后发生的脊髓硬膜下血肿是罕见但严重的并发症，通常与凝血病相关。我们报告一例27岁男性病例，该患者在外部机构接受诊断性腰椎穿刺后出现进行性下肢无力和尿失禁。脊柱MRI最初因神经根聚集和信号异常提示硬膜内肿瘤，从而延误了诊断。进一步评估发现此前未诊断出的血小板减少症（血小板计数<30,000）。患者在输注血小板后接受保守治疗，最终神经功能得到改善。该病例凸显了术前凝血筛查的迫切需求以及脊髓血肿非典型影像学表现所带来的诊断挑战。
