Spinal Ependymoma Identified Following Spinal Anesthesia for Cesarean Delivery

Neuraxial anesthesia is preferred over general anesthesia for cesarean delivery when appropriate because the latter is associated with a higher incidence of airway complications and an increased need for neonatal resuscitation. Common complications of neuraxial anesthesia include backache and headache, whereas feared but rare complications include paraplegia, intraspinal hemorrhage, cauda equina syndrome, nerve injury, and epidural hematoma. This case report presents a 40-year-old female with undiagnosed and asymptomatic ependymoma who presented with concerning neurological symptoms after receiving spinal anesthesia for elective cesarean delivery. Stat lumbar and thoracic spine magnetic resonance imaging (MRI) were performed on postoperative day 13 and were suggestive of a large hypervascular mass with areas of hemorrhage, concerning for ependymoma. An emergent laminectomy and mass resection were performed, resulting in an improvement in the patient’s neurological symptoms.