Abstract

We present a case report of a 6-week-old infant who initially presented with seizures localized to the right forearm and deviations of both eyes, which progressed to generalized involvement. The patient was admitted to the emergency room where imaging studies revealed a clavicle fracture and thin bilateral subdural posterior collections with recent re-bleeding in a chronic subdural hematoma (SDH). The patient's head circumference exhibited rapid growth, indicating an SDH originating from an emergency cesarean section. The patient also tested positive for COVID-19, highlighting the potential role of COVID-19 in the recurrence of bleeding. MRI showed recent typical neonatal arterial ischemic strokes (NAIS), a leading cause of perinatal brain injury. While the initial suspicion was child abuse, further investigation ruled it out. This case report emphasizes the importance of considering various etiologies in complex neonatal presentations, including SDH, COVID-19, and NAIS.