Acute intrathecal haematoma following neuraxial anaesthesia: diagnostic delay after apparently normal radiological imaging

We describe a case of intrathecal haematoma following combined spinal-epidural anaesthesia for caesarean section. The parturient was previously well with no risk factors for haematoma development. Surgical intervention was delayed, resulting in permanent neurological injury. Incorrect interpretation of clinical findings and magnetic resonance imaging contributed to the delay in definitive treatment. We discuss the difficulties in diagnosis, image interpretation and the need for a specialist opinion when abnormal neurological symptoms persist despite apparently normal imaging.