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Observation
Nov 2012

Acute Unilateral Hearing Loss as an Early Symptom of Lateral Cerebral Sinus Venous Thrombosis

Author Affiliations

Author Affiliations: Divisions of Neuroradiology (Dr Enzinger), Neuro-otology and Otorhinolaryngology (Dr Walch); Institute of Medical Informatics, Statistics, and Documentation (Dr Wünsch); and Department of Neurology (Drs Gattringer, Enzinger, Birner, Niederkorn, and Fazekas), Medical University of Graz, Graz, Austria.

Arch Neurol. 2012;69(11):1508-1511. doi:10.1001/archneurol.2012.346
Abstract

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 had acute 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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