A Case of Sudden Deafness with Intralabyrinthine Hemorrhage Intralabyrinthine Hemorrhage and Sudden Deafness

Abstract

Sudden hearing deterioration may occur in our population, but it is difficult to explain the exact pathophysiology and the cause. Magnetic resonance imaging (MRI) in sudden sensorineural hearing loss (SSNHL) is usually useful to evaluate neural lesions such as acoustic schwannoma and hemorrhage in labyrinth. Recently some cases of SSNHL caused by intralabyrintine hemorrhage were reported by the advance of MRI. In the case of intralabyrintine hemorrhage, MRI showed a hyperintense signal in the labyrinth on the pre-contrast and contrast enhanced T1-weighted image and relatively weak intensity on T2-weighted image. The prognosis SSNHL by intralabyrintine hemorrhage is generally known to be poor. We report a case of sudden deafness with intralabyrintine hemorrhage who has a history of anticoagulant administration, with a review of literature.

Keywords: Hearing loss; Labyrinth; Magnetic resonance imaging; Sudden.

Fig. 1. Pure tone audiometry tested 13 years ago showed moderate hearing loss (A), and complete hearing loss at present (B). Electronystagmography showed spontaneous nystagmus beating to right side at present (C). There was no canal paresis on caloric test (D).

Fig. 2. Internal auditory canal MRI scans. A: Pre-contrast T1-weighted coronal image shows a hyperintense signal from the right vestibule (arrow). B: After contrast administration, increased signal intensity is maintained from the right vestibule (arrow). C: T2-weighted coronal image shows almost same signal from right and left labyrinth.