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Spinal subdural hematoma following lumbar puncture occurred in a patient with embolic hemiplegia. The authors discuss the possible responsibility of heparin administered immediately after the tap. Physiological mechanisms of spinal subdural hematoma are reviewed. The authors emphasize the poor prognosis associated with this rare complication. They suggest that anticoagulant therapy be discontinued during and after a spinal tap. The first signs of medullary and radicular compression should be promptly recognized and an emergency neurosurgical procedure undertaken in order to forestall definitive paraplegia.
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