scholarly journals Sudden Bilateral Deafness in a Patient with Transient Ischemic Attack: A Case Report

2021 ◽  
pp. 119-122
Author(s):  
Caroline Ellinore Pihl ◽  
Christina Fredsby Back ◽  
Helle Klingenberg Iversen ◽  
Faisal Mohammad Amin
Keyword(s):  
Hearing Loss ◽  
Insular Cortex ◽  
Sudden Onset ◽  
Acute Onset ◽  
Motor Deficits ◽  
Ischemic Lesion ◽  
Ischemic Attack ◽  
The Right ◽  
Bilateral Deafness ◽  
Rare Symptom

Sudden-onset bilateral cortical deafness is a very rare symptom of stroke, but must be recognized as stroke, as it is a treatable condition, and the treatment is highly time dependent. We report a 53-year-old man with an acute onset of complete bilateral hearing loss that gradually improved spontaneously over 4 h. The hearing loss was explained by an infarction visualized on magnetic resonance imaging, which showed a subacute temporoparietal ischemic lesion in the left cerebral hemisphere involving the insular cortex and an older infarction in the right temporoparietal region. The location of these kinds of lesions may typically not cause motor deficits, but sensory and cognitive (e.g., aphasia) symptoms, which can be challenging to recognize in a suddenly deaf patient. Taking the possible differential diagnoses into account, immediate stroke workup should always be prioritized in patients with sudden bilateral deafness, as acute revascularizing treatment is possible.

scholarly journals Ischemic stroke with agraphestesia signal focus

2021 ◽  
Author(s):  
Ana Luísa Lopes Espínola da Costa Reis ◽  
Leonardo Henrique Gandolfi de Souza ◽  
Vitor Roberto Pugliesi Marques
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Parietal Lobe ◽  
Cerebral Arteries ◽  
Sudden Onset ◽  
Neurological Deficits ◽  
Motor Deficits ◽  
Ischemic Event ◽  
The Right ◽  
Sensory Ability

Introduction: The ischemic stroke is one of the main causes of death and disability in Brazil. Among the main risk factors are age, atrial fibrillation (AF), diabetes, dyslipidemia and physical inactivity. The main etiology of stroke is cardioembolic, resulting in obstruction of the cerebral arteries by a thrombus of cardiac origin. The artery most affected in ischemic strokes is the middle cerebral artery. The stroke has main characteristics, with emphasis on the sudden onset of symptoms, involvement of a focal area, ischemia caused by obstruction of a vessel and neurological deficits depending on the affected area. Graphesthesia is defined as a cutaneous sensory ability to recognize letters or numbers traced on the skin. The loss of this sensory ability is known as agraphesthesia. Case Report: M.A.F.O. female, 78a, arrived at the UPA complaining of mental confusion. Patient denies previous stroke. Personal history of systemic arterial hypertension. Upon physical examination, the patient was conscious, self and disoriented and inattentive. He was able to repeat and evoke words, without measurable motor déficits. Left upper limb with agraphestesia. Computed tomography was requested, which showed an extensive hypodense area in the right parietoccipital region, which leads to the erasure of the furrows between the adjacent gyres, which may correspond to a recent ischemic event. Magnetic resonance imaging, diffusion-restricted area with correspondence on the ADC map, located in the right temporoparietal region inferring an acute ischemic event. An electrocardiogram was also requested, which showed an irregular rhythm, characteristic of atrial fibrillation, resulting in a diagnostic hypothesis of cardioembolic ischemic stroke. Discussion: The involvement of post-central ischemic gyrus lesions may correspond to paresthesia, anesthesia, hypoesthesia; the involvement of secondary and terciary areas of sensitivity in the upper parietal lobe, especially in the active movements of the hand and in the modalities of integrated sensitivity, their lesions may be clinically affected by: apraxias, dysgraphias, hemineglect, agraphestesia, stereoagnosia and spacial disorientation.

Acute upward gaze palsy: Not always Parinaud syndrome

2019 ◽  
Vol 30 (6) ◽  
pp. NP5-NP6
Author(s):  
Salvatore Rossi ◽  
Giovanni Frisullo ◽  
Raffaele Iorio
Keyword(s):  
Brain Magnetic Resonance Imaging ◽  
Acute Onset ◽  
Thalamic Lesion ◽  
Ischemic Lesion ◽  
Thalamic Infarction ◽  
The Central Nervous System ◽  
Midbrain Infarction ◽  
Upward Gaze Palsy ◽  
The Right ◽  
Gaze Palsy

Introduction: Parinaud syndrome, caused by midbrain infarction, usually manifests as an ocular conjugate upgaze palsy. However, this sign should not point out straightforwardly to Parinaud syndrome, as other lesions in the central nervous system could cause it. Case description: The case of a 47-year-old woman showing acute onset of diplopia with bilateral upward gaze palsy is described. Parinaud syndrome was suspected on clinical grounds. However, brain magnetic resonance imaging displayed an acute ischemic lesion in the right anteromedial thalamus. Conclusions: Bilateral upward gaze palsy may be caused by unilateral thalamic infarction. The mechanism by which a unilateral thalamic lesion causes bilateral gaze palsy is discussed.

scholarly journals Deafness after COVID-19?

HNO ◽  
2021 ◽  
Author(s):  
K. Gerstacker ◽  
I. Speck ◽  
S. Riemann ◽  
A. Aschendorff ◽  
A. Knopf ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Hearing Loss ◽  
Acute Respiratory Distress Syndrome ◽  
Intensive Care ◽  
Severe Acute Respiratory Syndrome ◽  
Distress Syndrome ◽  
Profound Hearing Loss ◽  
Hearing Ability ◽  
The Right ◽  
Bilateral Deafness

AbstractThis article presents a case of sudden bilateral deafness in the context of a severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection and resultant coronavirus disease 2019 (COVID-19). After treatment in the intensive care unit for acute respiratory distress syndrome and acute kidney failure, hearing ability had drastically changed. While hearing had been subjectively normal before the infection, deafness was now measured on the left and profound hearing loss on the right ear. The patient was treated with cochlea implants on the left and a hearing aid in the right ear. The hearing loss is most likely a complication of COVID-19.

Langerhans' cell histiocytosis – A rare cause of sudden onset unilateral sensorineural hearing loss

1999 ◽  
Vol 113 (12) ◽  
pp. 1098-1100 ◽  
Author(s):  
I. Hore ◽  
R. B. Mitchell ◽  
G. Radcliffe ◽  
R. Quiney ◽  
T. Walker
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Langerhans Cell Histiocytosis ◽  
External Beam Radiotherapy ◽  
Sudden Onset ◽  
Langerhans Cell ◽  
Sensorineural Hearing ◽  
Magnetic Resonance Imaging Mri ◽  
One Year ◽  
The Right

AbstractLangerhans' cell histiocytosis is a rare disorder of unknown aetiology in which pathological Langerhans' cells accumulate and destroy local tissue. We report a 38-year-old female who presented with a sudden onset of left sensormeural hearing loss. Magnetic resonance imaging (MRI) revealed a contrast-enhancing lesion in the left mastoid and a second lesion in the hypothalamus. Following left mastoid exploration and biopsy a definitive diagnosis of Langerhans' cell histiocytosis was made and the patient was treated with external beam radiotherapy. Subsequent right femur and right mastoid involvement were successfully treated with steroids and cytotoxic chemotherapy. At one year follow-up the patient had residual left-sided sensorineural hearing loss with normal hearing in the right ear. To our knowledge, Langerhans' cell histiocytosis has not been previously reported as a cause of unilateral sudden onset sensorineural hearing loss. It should be considered in the differential diagnosis of this condition.

scholarly journals Acromegaly remission, SIADH and pituitary function recovery after macroadenoma apoplexy

2019 ◽  
Vol 2019 ◽  
Author(s):  
E Sanz-Sapera ◽  
S Sarria-Estrada ◽  
F Arikan ◽  
B Biagetti
Keyword(s):  
Pituitary Apoplexy ◽  
Hormone Secretion ◽  
Spontaneous Remission ◽  
Pituitary Tumour ◽  
Sudden Onset ◽  
Acute Onset ◽  
Clinical Syndrome ◽  
Pituitary Function ◽  
List Type ◽  
The Right

Summary Pituitary apoplexy is a rare but potentially life-threatening clinical syndrome characterised by ischaemic infarction or haemorrhage into a pituitary tumour that can lead to spontaneous remission of hormonal hypersecretion. We report the case of a 50-year-old man who attended the emergency department for sudden onset of headache. A computed tomography (CT) scan at admission revealed pituitary haemorrhage and the blood test confirmed the clinical suspicion of acromegaly and an associated hypopituitarism. The T1-weighted magnetic resonance imaging (MRI) showed the classic pituitary ring sign on the right side of the pituitary. Following admission, he developed acute-onset hyponatraemia that required hypertonic saline administration, improving progressively. Surprisingly, during the follow-up, IGF1 levels became normal and he progressively recovered pituitary function. Learning points: Patients with pituitary apoplexy may have spontaneous remission of hormonal hypersecretion. If it is not an emergency, we should delay a decision to undertake surgery following apoplexy and re-evaluate hormone secretion. Hyponatraemia is an acute sign of hypocortisolism in pituitary apoplexy. However, SIADH although uncommon, could appear later as a consequence of direct hypothalamic insult and requires active and individualised treatment. For this reason, closely monitoring sodium at the beginning of the episode and throughout the first week is advisable to guard against SIADH. Despite being less frequent, if pituitary apoplexy is limited to the tumour, the patient can recover pituitary function previously damaged by the undiagnosed macroadenoma.

scholarly journals Transient Anarthria and Quadriplegia in a Patient with Basilar Artery Hypoplasia and Coincidental Intracranial Lipoma: A Case Report

2018 ◽  
Vol 10 (3) ◽  
pp. 322-327
Author(s):  
Kyu-On Jung ◽  
Seung-Jae Lee ◽  
Hyung Jun Kim ◽  
Deokhyun Heo ◽  
Jeong-Ho Park
Keyword(s):  
Basilar Artery ◽  
Holter Monitoring ◽  
Sudden Onset ◽  
Predisposing Factor ◽  
Ischemic Lesion ◽  
Tomographic Images ◽  
Intracranial Lipoma ◽  
Computed Tomographic ◽  
Vertebrobasilar System ◽  
Ischemic Attack

Cerebral ischemia may be rarely associated with a hypoplastic vertebrobasilar system. Intracranial lipoma is also a very rare congenital malformation. We report the case of a 52-year-old woman with vertebrobasilar transient ischemic attack associated with basilar artery hypoplasia and coincidental intracranial lipoma. She presented with sudden-onset dizziness, anarthria, and quadriplegia lasting for about 30 min. The patient’s initial blood pressure was measured at 200/120 mm Hg. The magnetic resonance and computed tomographic images showed the absence of an acute ischemic lesion in the brain but revealed a hypoplasia of the basilar artery and bilateral V4 vertebral arteries. A lipoma of 11 mm in long diameter was also found in the quadrigeminal cistern and at the superior vermis. The electroencephalography, transthoracic echocardiogram, 24-h Holter monitoring, and transcranial Doppler ultrasonography, including patent foramen ovale study, were all noted as negative. The patient was treated with oral aspirin 100 mg, atorvastatin 10 mg, and antihypertensive medication. She had no symptom recurrence after the treatment. Our case suggests that hypoplasia of the vertebrobasilar arteries can be a predisposing factor for posterior circulation ischemia, especially when additional vascular risk factors coexist.

scholarly journals Intraoperative awake brain mapping and multimodal image-guided resection of dominant side insular glioma

2018 ◽  
Vol 45 (VideoSuppl2) ◽  
pp. V2
Author(s):  
Zhengda Yu ◽  
N. U. Farrukh Hameed ◽  
Nan Zhang ◽  
Bin Wu ◽  
Jie Zhang ◽  
...  
Keyword(s):  
Tumor Resection ◽  
Significant Risk ◽  
Sudden Onset ◽  
Motor Deficits ◽  
Image Guided ◽  
Patient Consent ◽  
Preserve Function ◽  
The Right ◽  
Dominant Side ◽  
Informed Patient

Resection of insular tumors in the dominant hemisphere poses a significant risk of postoperative motor and language deficits. The authors present a case in which intraoperative awake mapping and multi-modal imaging was used to help preserve function while resecting a dominant insular glioma. The patient, a 55-year-old man, came to the clinic after experiencing sudden onset of numbness in the right limbs for 4 months. Preoperative MRI revealed a nonenhancing lesion in the left insular lobe. Gross-total tumor resection was achieved through the transcortical approach, and the patient recovered without language or motor deficits. Informed patient consent was obtained.The video can be found here: https://youtu.be/gFky09ekmzw.

A cerebralis amyloid angiopathia radiológiai megjelenési formái

2018 ◽  
Vol 159 (11) ◽  
pp. 439-444
Author(s):  
Sándor Csizmadia ◽  
Erika Vörös
Keyword(s):  
Cerebral Hemorrhage ◽  
Correct Diagnosis ◽  
Cerebral Atrophy ◽  
Sudden Onset ◽  
Superficial Siderosis ◽  
Amyloid Angiopathy ◽  
Vascular Events ◽  
Ischemic Lesion ◽  
Mri Scans ◽  
The Right

Abstract: Cerebral amyloid angiopathy (CAA) is most commonly recognized by β-amyloid deposition in the small and medium sized vessels of the brain. The 71-year-old female presented with a sudden onset of vertigo and headache. By native computer tomography (CT) examination we found cerebral atrophy and the sign of chronic vascular injury. The complaints of the patient worsened, thus magnetic resonance imaging (MRI) was performed. The MRI scan revealed a bleeding transformation of an ischemic lesion in the right occipital region. On the susceptibility weighted scans we could observe old microbleedings, thus we suspected CAA. The patient later re-presented at the clinic with a sudden onset of right sided hemiplegia. We performed a native CT scan which identified cerebral hemorrhage in atypical position confirming our diagnosis. CAA has many radiological presentations. The most important is the lobar cerebral hemorrhage. On the susceptibility weighted MRI scans, we could identify the microbleeds and the superficial siderosis by the deposition of the hemosiderin. The subarachnoid hemorrhage is a sign of bad outcome. In the white matter, we could detect the change of the related inflammation and the leukoaraiosis. Further, two not specific abnormalities can be important as well, such as extended ischemic lesions and perivascular space dilatation. CAA has various appearances on MRI. Repeated vascular events and dementia in old age patients draw attention to its presence. The correct diagnosis can be made with the right interpretation of the patient’s complaints in combination with the radiological abnormalities. Orv Hetil. 2018; 159(11): 439–444.

Republished: Improvement of sudden bilateral hearing loss after vertebral artery stenting

2015 ◽  
Vol 8 (3) ◽  
pp. e12-e12 ◽  
Author(s):  
Ji Hwa Kim ◽  
Kyung Jin Roh ◽  
Sang Hyun Suh ◽  
Kyung-Yul Lee
Keyword(s):  
Hearing Loss ◽  
Vertebral Artery ◽  
Posterior Inferior Cerebellar Artery ◽  
Reperfusion Therapy ◽  
Sudden Onset ◽  
Acute Infarction ◽  
Vertebrobasilar Ischemia ◽  
Left Posterior ◽  
Bilateral Sensorineural Hearing Loss ◽  
Bilateral Deafness

Bilateral deafness is a rare but possible symptom of vertebrobasilar ischemia. We report a case of sudden bilateral sensorineural hearing loss caused by bilateral vertebral artery (VA) occlusion which dramatically improved after stenting. A 54-year-old man was admitted with sudden onset of bilateral deafness, vertigo, and drowsy mental status. Brain diffusion-weighted MRI showed acute infarction involving both the posterior inferior cerebellar artery and left posterior cerebral artery territory. Cerebral angiography showed bilateral distal VA occlusion, and emergency intracranial stenting was performed in the left VA. After reperfusion therapy his symptoms gradually improved, including hearing impairment. Endovascular stenting may be helpful in a patient with sudden deafness caused by bilateral VA occlusion.

The Occlusion Effect in Unilateral Functional Hearing Loss

1970 ◽  
Vol 13 (1) ◽  
pp. 37-40
Author(s):  
Gary Thompson ◽  
Marie Denman
Keyword(s):  
Hearing Loss ◽  
Bone Conduction ◽  
Low Frequency ◽  
Clinical Implications ◽  
The Right ◽  
Occlusion Effect

Bone-conduction tests were administered to subjects who feigned a hearing loss in the right ear. The tests were conducted under two conditions: With and without occlusion of the non-test ear. It was anticipated that the occlusion effect, a well-known audiological principle, would operate to draw low frequency bone-conducted signals to the occluded side in a predictable manner. Results supported this expectation and are discussed in terms of their clinical implications.

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