Nakayama T, Nobuoka H, Wada S, Matsukado Y
No To Shinkei. 1986 Jun;38(6):565-70.
A case of cortical deafness is reported, which was caused by two episodes of bilateral hypertensive putaminal hemorrhage. Such a case has not appeared in literature up to this time. The patient was a right-handed, 69-year-old man, admitted to us after the stroke with right hemiparesis and disturbance of consciousness. CT scans showed right putaminal hemorrhage. After recovery of consciousness, the patient complained of hearing difficulty of the right ear. The right hemiparesis improved and he was followed ambulatorily after two months hospitalization. He returned to his work and was able to drive a car. His hearing difficulty of the right ear progressed and became stone deaf six months after onset of the initial stroke. Two years after the first stroke, he was attacked by the second stroke with left hemiparesis. CT scans showed left putaminal hemorrhage larger than the previous one in the right. When the patient recovered consciousness, he complained of total deafness. Audiometry test showed that hearing was lost completely to both high and low notes, and there was absence of bone conduction bilaterally. Auditory brain stem response test revealed normal pattern from wave I through wave V bilaterally. Middle latency response showed normal component Po on the right ear and it was absent on the left. The component Pa was not identified on both ears. He showed skill and reliance on lip reading two years after the onset of the complete deafness. Now he can speak fluently and communicate with lip reading and written language, although no improvement of the complete deafness being noticed.(ABSTRACT TRUNCATED AT 250 WORDS)
报告了一例皮质聋病例,其由两次双侧高血压性壳核出血发作引起。截至目前,此类病例在文献中尚未出现。患者为一名69岁右利手男性,中风后因右侧偏瘫和意识障碍入院。CT扫描显示右侧壳核出血。意识恢复后,患者主诉右耳听力困难。右侧偏瘫有所改善,住院两个月后改为门诊随访。他恢复了工作且能够开车。其右耳听力困难逐渐加重,在首次中风发作六个月后完全失聪。首次中风两年后,他再次中风,出现左侧偏瘫。CT扫描显示左侧壳核出血比右侧先前的出血更大。患者意识恢复后,主诉完全失聪。听力测试显示高低音均完全丧失,双侧骨导消失。听觉脑干反应测试显示双侧从波I到波V的模式正常。中潜伏期反应显示右耳有正常的Po成分,左耳则无。双耳均未识别出Pa成分。完全失聪两年后,他表现出了唇读技巧和对唇读的依赖。现在他能流利地说话,通过唇读和书面语言进行交流,尽管完全失聪没有改善。(摘要截取自250字)