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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 rec