Ogane K, Fujii Y, Hatanaka M
Department of Neurosurgery, Towada City Hospital, Japan.
No To Shinkei. 1998 May;50(5):443-6.
A 64-year-old female came to our department because of a sudden onset of bilateral deafness 2 days before. She had sudden onset of mild headache, nausea and vomiting 9 days before, but was diagnosed as food poisoning by her home doctor. Her symptoms disappeared on the following day. Neurological examination revealed bilateral deafness, right facial palsy of central type and very slight neck stiffness. CT showed inconspicuous subarachnoid hemorrhage, but lumber puncture revealed definite subarachnoid hemorrhage. Another important finding of CT was old left temporal lobe infarction. Cerebral angiography detected right middle cerebral artery aneurysm at the trifurcation and moderate cerebral vasospasm of the right M2 portion. Neck clipping was successfully performed, but small size of right temporal lobe infarction was found on postoperative CT, which was due to cerebral vasospasm. Postoperative MRI showed bilateral temporal lobe infarction, especially including bilateral auditory cortex. This finding suggests that her deafness was cortical in origin.
一名64岁女性因两天前突然出现双侧耳聋前来我院就诊。9天前她突然出现轻度头痛、恶心和呕吐，但其家庭医生诊断为食物中毒。次日她的症状消失。神经系统检查发现双侧耳聋、右侧中枢性面瘫和非常轻微的颈部僵硬。CT显示蛛网膜下腔出血不明显，但腰椎穿刺显示确诊为蛛网膜下腔出血。CT的另一个重要发现是左侧颞叶陈旧性梗死。脑血管造影检测到右侧大脑中动脉在三叉处有动脉瘤，右侧M2段有中度脑血管痉挛。成功进行了颈部夹闭术，但术后CT发现右侧颞叶有小面积梗死，这是由脑血管痉挛所致。术后MRI显示双侧颞叶梗死，尤其累及双侧听觉皮层。这一发现提示她的耳聋源于皮层。
