RT Journal Article SR Electronic T1 Recurrent migraine aura-like symptoms in an elderly woman: symptomatic cortical spreading depression? JF BMJ Case Reports JO BMJ Case Reports FD BMJ Publishing Group Ltd SP e241479 DO 10.1136/bcr-2020-241479 VO 14 IS 7 A1 Kerstin Glössmann A1 Christoph Baumgartner A1 Johannes Peter Koren A1 Franz Riederer YR 2021 UL http://casereports.bmj.com/content/14/7/e241479.abstract AB Cortical spreading depression (CSD) has been directly observed in humans with malignant stroke, traumatic brain injury and subarachnoid haemorrhage and is also considered to be the correlate of migraine aura. We report on a 76-year-old woman with new-onset episodes of headache, paraesthesia, hemiparesis and dysarthria, in whom a small cortical subarachnoid haemorrhage was diagnosed with MRI. Repeated diffusion-weighted MRI scans shortly after transient focal neurological episodes as well as diagnostic workup were normal, which makes recurrent transient ischaemic attacks unlikely. Ictal electroencephalogram recordings showed no epileptic activity. Long-term follow-up revealed a diagnosis of probable cerebral amyloid angiopathy. We propose that CSD could be a pathophysiological correlate of transient focal neurological deficits in patients with cortical bleeding.