Partial Recovery of Audiological, Vestibular, and Radiological Findings following Spontaneous Intralabyrinthine Haemorrhage

Abstract

The diagnosis, work-up, and treatment of sudden sensorineural hearing loss and sudden vestibular loss vary widely between units. With the increasing access to both magnetic resonance imaging and objective vestibular testing, our understanding of the various aetiologies at hand is increasing. Despite this, the therapeutic options are limited and without a particularly strong evidence base. We present a rare, yet increasingly diagnosed, case of intralabyrinthine haemorrhage (ILH) together with radiological, audiological, and vestibular test results. Of note, this occurred spontaneously and has shown partial recovery in all the mentioned modalities.

Figure 1

Pure tone audiogram at presentation (a) and at 3-month follow-up (b).

Figure 2

Video head impulse tests of the lateral semicircular canals at presentation (a) and at 3-month follow-up (b). Both show significant left sided correction saccades. DVA results however improved during follow-up.

Figure 3

(a) T1 weighted native MRI of the petrous bone showing hemorrhage in the vestibule (arrow) and in the semicircular canals (partly shown, striped arrow) and slightly in the basal (not shown) and second turn (arrowhead) of the cochlea on the left. (b) 3-month follow-up shows clear resolution of the hemorrhage. Only slight residual blood is visible in the vestibulum (arrow) and in the semicircular canals (partly shown, striped arrow).