spinal subdural hematoma with paraplegia mimicking dorsolumbar prolapsed disc: a case report

Background and importance: spinal subdural hematoma (ssh) is a rare condition with an unknown incidence in the general population. iatrogenic spinal subdural hematoma radiologically mimicking a prolapsed dorsolumbar disc has not been published in the literature. case presentation: a 65-year-old female presented with altered sensorium and generalized weakness for 3 days evaluated by a neurologist who diagnosed it as a metabolic encephalopathy with syndrome of inappropriate antidiuretic hormone secretion (siadh) with severe anemia and hypothyroidism. she underwent a diagnostic lumbar puncture and following which, within 24 hours, she developed weakness of both the lower limbs. mri of dorsolumbar spine was done which revealed d12-l1 extruded disc causing severe compression to the conus medullaris with d12-l2 subarachnoid lesion and cord edema. on opening the dura, a large organized hematoma on the anterior aspect of the conus was seen and evacuated. conclusion: spinal subdural hematoma presents with a spectrum of signs and symptoms. although mri is the investigation of choice but ssh presenting like a prolapsed intervertebral disc on mri is one of its kinds and should be kept in mind since it carries a grave prognosis if not treated early with emergency decompression.