Acute unilateral hearing loss as an early symptom of lateral cerebral sinus venous thrombosis

Thomas Gattringer, Christian Enzinger, Armin Birner, Gerit Wünsch, Kurt Niederkorn, Christian Walch, Franz Fazekas
Archives of Neurology 2012, 69 (11): 1508-11

BACKGROUND: Increasing availability of neuroimaging has facilitated the diagnosis of cerebral sinus venous thrombosis(CSVT). However, CSVT may also present with unspecific or atypical symptoms, resulting in diagnostic delay.Single reports suggested otologic symptoms as such pitfalls.

OBJECTIVE: To screen patients with CSVT for otologic symptoms.

DESIGN: Ten-year retrospective case series.

SETTING: Primary and tertiary care university clinic.

PATIENTS: Thirty-eight patients with CSVT.

RESULTS: Of 38 patients with CSVT, 3 individuals hadacute unilateral hearing loss, 2 of which also had concomitant tinnitus and headache, and were initially treated at the ear, nose, and throat department. Magnetic resonance imaging after hospital discharge showed ipsilateral thrombosis of the lateral venous sinus. Two female patients took oral contraceptives, 1 of whom also had a heterozygous factor V Leiden mutation.

CONCLUSIONS: Cerebral sinus venous thrombosis may present with unspecific symptoms such as acute unilateral hearing loss. If in conjunction with headache or risk factors for venous thrombosis, the suspicion of ipsilateral lateral CSVT should prompt rapid imaging including venography.

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