• Diana De Carvalho, Saleh Almenawer, Marco Lozej, Heather Noble, and Naresh K Murty.
• Health Performance Centre, University of Guelph, Guelph, Ontario, Canada; Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada. Electronic address: ddecarva@uwaterloo.ca.
• World Neurosurg. 2013 Nov 1;80(5):654.e9-11.

BackgroundChronic subdural hematoma is a common presentation to the neurosurgical practice that tends to occur among the elderly.MethodsWe identify a rare occurrence of a chronic subdural hematoma in a young and otherwise healthy female patient who denied a traumatic brain injury.ResultsUpon reviewing the literature, we found only one reported case of a spontaneous nature in a young patient. The subtle presentation of headaches and absence of neurological deficit could be mistaken as migraine and result in a delay in obtaining imaging and necessary treatment. In this report, we present a 22-year-old patient who complained of persistent headaches and was neurologically intact on examination. Cranial computed tomography revealed the presence of a right-sided chronic subdural hematoma; this was followed by magnetic resonance imaging plus angiogram, which ruled out the presence of a vascular abnormality. A burr-hole craniostomy procedure was used that resulted in resolution of symptoms.ConclusionWithout a heightened clinical suspicion, a similar presentation could be missed, resulting in delayed management.Copyright © 2013 Elsevier Inc. All rights reserved.

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