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Department of Neurosurgery, Gülhane Military Medical Academy, Ankara, Turkey Although primary intradural-extramedullary ependymomas arising from the cauda equina or filum terminale are not rare, spinal ependymoma as a possible cause of chronic spinal subdural hematoma (CSSDH) following lumbar puncture has not been reported in the literature previously. A patient with progressive neurological deficit following lumbar puncture due to a CSSDH is presented. Possible mechanisms of spinal subdural hematoma are discussed. Magnetic resonance imaging (MRI) study of the lumbar region revealed the coexistence of chronic spinal subdural hematoma with the spinal tumor (ependymoma). The CSSDH was evacuated and the tumor was resected totally. Surgical evacuation of hematoma and total resection of the tumor resulted in almost complete recovery. A patient with progressive neurological deficit following a lumbar puncture should make us consider the coexistence of CSSDH with a spinal ependymoma. Keywords : Ependymoma, Lumbar puncture, Subdural hematoma, Spinal tumor