Pihl Caroline Ellinore, Back Christina Fredsby, Iversen Helle Klingenberg, Amin Faisal Mohammad
Department of Neurology, Rigshospitalet Glostrup, University of Copenhagen, Copenhagen, Denmark.
Case Rep Neurol. 2021 Feb 16;13(1):119-122. doi: 10.1159/000512403. eCollection 2021 Jan-Apr.
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.
突发双侧皮质聋是一种非常罕见的中风症状，但必须被认定为中风，因为这是一种可治疗的病症，且治疗具有高度的时间依赖性。我们报告一例53岁男性，急性起病，双侧听力完全丧失，并在4小时内逐渐自发改善。磁共振成像显示的梗死灶解释了听力丧失的原因，该梗死灶表现为左侧大脑半球涉及岛叶皮质的亚急性颞顶叶缺血性病变以及右侧颞顶叶区域的陈旧性梗死。这类病变的位置通常不会导致运动功能缺损，而是引起感觉和认知（如失语）症状，这在突然失聪的患者中可能难以识别。考虑到可能的鉴别诊断，对于突发双侧耳聋的患者，应始终优先进行急性中风检查，因为有可能进行急性血管再通治疗。
