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The authors report a case of chronic subdural hematoma/effusions (CSDHs) first suspected at 3 months of age after presenting with a seizure, and initially diagnosed as postnatal trauma. However, a close re-examination of fortuitously available serial prenatal ultrasounds clearly establishes the presence of an abnormal, expansive intracranial process already in place by 20-weeks gestation. With no identified prenatal, perinatal, or postnatal trauma, and no identified culpable medical condition as a potential etiology, this case raises the possibility that some, perhaps many or even most CSDHs of infancy can have a congenital etiology.

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