Acute paraplegia following epidural anesthesia for cesarean delivery due to asymptomatic spinal cord ependymoma hemorrhage: A case report and literature review.

RATIONAL: Ependymoma is the most common spinal cord tumor in the adult population, but it is, nevertheless, very rare. Most patients have no symptoms or only nonspecific symptoms. Intraspinal anesthesia is the preferred anesthetic technique for obstetric surgery because it has minimal effects on the fetus. Spinal anesthesia causing hemorrhage into spinal tumor have been reported, but very few have been for epidural anesthesia.

PATIENT CONCERNS AND DIAGNOSIS: We describe a case of a 36-year-old female patient who presented with acute paraplegia due to after undergoing a cesarean section under epidural anesthesia. Magnetic resonance imaging suggested the possibility of subdural intratumoral hemorrhage.

INTERVENTIONS AND OUTCOMES: An emergency laminectomy, at T12-to-L1 level, was performed 39 hours after the cesarean section to decompress the spinal cord. An ependymoma was diagnosed after examination of the pathological specimen. She received physical rehabilitation support after surgery. The patient was left with residual motor and sensory deficits finally.

LESSONS: Early identification and early surgery minimize the risk of severe neurological deficit following acute spinal cord compression.