title: Episodic Aphasia Associated With Cortical Spreading Depression After Subdural Hemorrhage Evacuation.
abstract: Cortical spreading depression (CSD) has been associated with many pathological entities including migraine, trauma, hemorrhage, and mitochondrial disease. The clinical diagnosis remains challenging without the other concomitant features such as headache because CSD can mimic seizure or acute stroke. Wereport of a 77 year-old right handed man with a left subdural hematoma evacuation that subsequently developed episodic aphasia, slurred speech, right nasolabial fold flattening, and right pronator drift. In this case report, we discuss our multimodal diagnostic approach and treatment in a patient with episodic aphasia and neurological deficits in order to propose the diagnosis of cortical spreading depression. CSD should be considered when focal deficits in brief episodes occur after stroke and seizures have been ruled out. Treatment choices as illustrated by this case report can have an impact on outcome and resolution of episodes.
authors.affiliation: Department of Neurology, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, USA.
authors.forename: Nirav H
authors.initials: NH
authors.lastname: Shah
authors.affiliation: Department of Neurology, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, USA.
authors.forename: David
authors.initials: D
authors.lastname: Adams
keywords: cerebrovascular disorders; cerebrovascular trauma; clinical specialty; disorders; headache; imaging; migraine disorders; nervous system; neurohospitalist; techniques; trauma