Nakayama T, Harada M, Wada S, Matsukado Y
No Shinkei Geka. 1985 Oct;13(10):1129-32.
A case of head injury is reported because it presented such an unusual symptom as sudden, bilateral complete deafness. An 11-year-old boy was involved in a traffic accident while riding on a bicycle. He was admitted immediately after the accident in semicomatose state. The pupils were isocoric and pupillary light reflex was normal. Conjugate deviation to the right was seen. Oculo-cephalic response was absent. X-rays of his skull showed two linear fractures in the occipital bone. CT scan of the head showed symmetrical ventricular dilatation which was suspected to be a sequela of asphyxia at his birth although there was no obvious finding of cerebral contusion. His mental and physical development had been uneventful. One week after admission, his consciousness improved to some extent and at that time right hemiparesis and right infranuclear facial palsy were revealed. One month after the accident, he became alert and able to eat and to read the books on the bed, and then bilateral deafness was noticed. Audiometry showed that hearing was lost completely to both high and low notes, and there was absence of bone conduction bilaterally. Auditory brainstem response test revealed no response from wave I through wave V bilaterally. Right hemiparesis and right infranuclear facial palsy completely subsided and his mental and intellectual state became normal. He was discharged ambulatorily in good condition except for bilateral complete deafness. Now he is leading a useful life and attending a prefectural deaf and mute school.(ABSTRACT TRUNCATED AT 250 WORDS)
本文报告一例头部损伤病例,因其出现了如突发性双侧完全性耳聋这样不寻常的症状。一名11岁男孩在骑自行车时遭遇交通事故。事故发生后他立即被送入医院,处于半昏迷状态。双侧瞳孔等大,瞳孔对光反射正常。可见双眼向右同向偏斜。眼前庭反射消失。颅骨X线片显示枕骨有两条线性骨折。头部CT扫描显示脑室对称扩张,尽管没有明显的脑挫伤迹象,但怀疑这是其出生时窒息的后遗症。他的智力和身体发育一直正常。入院一周后,他的意识有所改善,此时发现有右侧偏瘫和右侧核下性面瘫。事故发生一个月后,他变得清醒,能够在床上吃饭和看书,随后发现双侧耳聋。听力测试显示,高低音听力均完全丧失,双侧骨传导消失。双侧听觉脑干反应测试显示从I波到V波均无反应。右侧偏瘫和右侧核下性面瘫完全消退,他的精神和智力状态恢复正常。除双侧完全性耳聋外,他情况良好,已出院并能正常活动。现在他过着充实的生活,就读于一所县级聋哑学校。(摘要截选于250字)