Anticoagulation-related spinal subdural hematoma following endovascular intervention: A case resulting in paraplegia

Spinal subdural hematoma is a rare but potentially devastating neurosurgical emergency associated with high morbidity, particularly when diagnosis and surgical intervention are delayed. Patients receiving long-term anticoagulation are at increased risk for spontaneous spinal hemorrhage, even in the absence of significant trauma. We present the case of a 68-year-old man on chronic oral anticoagulation for peripheral arterial disease who developed acute paraplegia following an endovascular intervention. Delayed diagnosis led to postponed surgical decompression and resulted in irreversible neurological deficits. This case highlights the need for heightened clinical suspicion and immediate spinal imaging in anticoagulated patients, as delayed recognition of spinal hemorrhage may lead to irreversible neurological outcomes.