# Non-traumatic Subdural Hematoma: A Rare Presentation of Cerebral Venous Sinus Thrombosis

## TL;DR

A rare case shows how a non-traumatic subdural hematoma can be caused by cerebral venous sinus thrombosis, highlighting the need for better diagnostic approaches.

## Contribution

This case report highlights the importance of considering CVST as a rare cause of SDH and emphasizes the role of contrast-enhanced imaging for accurate diagnosis.

## Key findings

- CVST can present as a non-traumatic subdural hematoma and is often missed with traditional imaging.
- Contrast-enhanced imaging with venography is more effective in diagnosing CVST.
- Anticoagulation is the primary treatment for CVST to prevent complications.

## Abstract

Cerebral venous sinus thrombosis (CVST) is rare and often overlooked, sometimes presenting as an unexplained subdural hematoma (SDH) without trauma. It very rarely accounts for a small proportion of all stroke cases, but carries significant morbidity and mortality if not promptly recognized and treated. We report the case of a middle-aged female who presented with a severe headache, initially diagnosed with SDH, with subsequent imaging revealing extensive dural venous sinus thrombosis. This case underscores the need to consider etiologies beyond conventional causes, including hypertension, trauma, and arterial aneurysm, in patients with intracerebral hemorrhage. Traditional non-contrast neuroimaging often fails to detect these rare thrombotic disorders. In contrast, contrast-enhanced imaging, especially with venography, promptly identifies the pathology. Anticoagulation remains the cornerstone of treatment for dural venous sinus thrombosis, as it prevents thrombus propagation and facilitates recanalization. Improved awareness, a high index of suspicion, and advanced imaging modalities are crucial for accurate diagnosis and, consequently, prompt management.