| Summary: | Abstract Background Chronic subdural hematoma (CSDH) is a common condition in elderly patients, typically diagnosed through neuroimaging techniques such as computed tomography (CT) and magnetic resonance imaging (MRI). Cases of subdural lymphoma mimicking chronic subdural hematoma are exceedingly rare and present significant diagnostic challenges for emergency physicians. Case presentation A 71-year-old female patient with subdural lymphoma was initially diagnosed with CSDH based on her medical history, clinical presentation, and neuroimaging findings. However, postoperative pathology revealed diffuse subdural lymphoma. Although the patient’s symptoms initially improved following standard lymphoma treatment, the disease recurred within 14 months of follow-up. The patient ultimately succumbed to malignant intracranial hypertension 15 months after discharge. Conclusions This article discusses the neuroimaging findings, histological features, and treatment strategies of this case, while reviewing the limited number of similar cases reported since 2000. Based on the diagnostic and therapeutic experience of this case, it is recommended that when a patient’s clinical presentation deviates from that of typical chronic subdural hematoma, supplementary MRI with diffusion-weighted imaging (DWI) should be considered to aid in differential diagnosis.
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