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单侧突发听力损失作为烟雾病的首发症状

Unilateral sudden hearing loss as the first presenting symptom of moyamoya disease.

作者信息

Tseng L-S, Luo S-D

机构信息

Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.

出版信息

J Laryngol Otol. 2013 Feb;127(2):196-9. doi: 10.1017/S002221511200309X. Epub 2013 Jan 15.

Abstract

OBJECTIVE

We describe a rare case of sudden onset of unilateral sensorineural hearing loss occurring as the first symptom of moyamoya disease, which is characterised by progressive stenosis of the intracranial internal carotid arteries and their proximal anterior cerebral arteries and middle cerebral arteries.

METHOD

Case report and review of the world literature regarding moyamoya disease with hearing loss.

RESULTS

The reported patient had moyamoya disease that initially presented as sudden, unilateral sensorineural hearing loss. Magnetic resonance imaging showed occlusion of the anterior cerebral, middle cerebral and distal internal carotid arteries bilaterally. The possible mechanism of this patient's sudden sensorineural hearing loss may have been vascular occlusion resulting from thrombotic narrowing or blockage by plaque.

CONCLUSION

The described patient represents the first reported case of sudden onset, unilateral sensorineural hearing loss occurring as the first symptom of moyamoya disease. The possibility of a vascular lesion such as moyamoya disease should be considered in patients with sudden sensorineural hearing loss, especially children, young adults and Asian patients. Due to this disease's poor outcome, early diagnosis and treatment are important to prevent stroke.

摘要

目的

我们描述了一例罕见病例,以单侧感音神经性听力损失突然发作为烟雾病的首发症状,烟雾病的特征是颅内颈内动脉及其近端大脑前动脉和大脑中动脉进行性狭窄。

方法

病例报告及对世界范围内有关伴有听力损失的烟雾病的文献进行回顾。

结果

报告的患者患有烟雾病,最初表现为突然的单侧感音神经性听力损失。磁共振成像显示双侧大脑前动脉、大脑中动脉及颈内动脉远端闭塞。该患者突然发生感音神经性听力损失的可能机制可能是血栓性狭窄或斑块阻塞导致的血管闭塞。

结论

所描述的患者是首例报告的以单侧感音神经性听力损失突然发作为烟雾病首发症状的病例。对于突然发生感音神经性听力损失的患者,尤其是儿童、年轻人和亚洲患者,应考虑烟雾病等血管病变的可能性。由于这种疾病预后较差,早期诊断和治疗对于预防中风很重要。

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