Chronic subdural hematoma presenting with symptoms of transient ischemic attack (TIA): a case report

Rarely, chronic subdural hematomas (CSDH) will present with symptoms mimicking transient ischemic attacks (TIAs). We report the case of an elderly man who presented with intermittent numbness and weakness of his left upper extremity typical of symptoms arising from a right sensorimotor cortex TIA. He was treated with empiric antiplatelet therapy for several days before a head CT was performed. The head CT and a subsequent MRI showed a CSDH with an acute component and cortical compression. Upon evacuation of the hematoma, his symptoms resolved. In cases of suspected TIA, a head CT should always be performed before beginning antiplatelet therapy. If there is an underlying hematoma, such therapy is dangerous, as it can potentiate more bleeding and leave the true pathology unaddressed.