- Spinal hematoma is a rare but serious complication of central neuraxial blockade like spinal anesthesia and epidural anesthesia. It can cause neurological deficits if not treated urgently. - Common risk factors include patient factors like coagulopathies, procedure factors like difficult blocks, and drug factors like anticoagulants and antiplatelets. Low molecular weight heparins are a common cause of drug-related spinal hematomas. - Guidelines recommend minimum time intervals between neuraxial procedures or catheter manipulations and anticoagulant/antiplatelet doses to reduce risk. These intervals are based on drug half-lives and time for clot stabilization. Strict adherence to guidelines is important for patient safety.