We thank Gokhale for his comment on our recent article,1 where we described 3 patients with isolated lateral cerebral sinus venous thrombosis and associated ipsilateral acute hearing loss as the presenting sign. As possible pathophysiological mechanisms underlying hypacusis, we proposed (1) impeded venous drainage of the cochlea to the thrombosed lateral sinus system and consecutive alteration of the inner ear's microcirculation and (2) dysfunction of the cochlea and/or the vestibulocochlear nerve due to increased intracranial pressure (ICP). The author questions the second explanation.
Gattringer T, Enzinger C, Fazekas F. Acute Unilateral Hearing Loss as an Early Symptom of Lateral Cerebral Sinus Venous Thrombosis—Reply. JAMA Neurol. 2013;70(5):655–656. doi:10.1001/jamaneurol.2013.159
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