| Reversible cortical auditory dysfunction caused by cerebral vasospasm after ruptured aneurysmal subarachnoid hemorrhage and evaluated by perfusion magnetic resonance imaging. Case report. | |
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MedLine Citation:
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PMID: 17639887 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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A 52-year-old woman developed subarachnoid hemorrhage (SAH) caused by a ruptured right internal carotid artery (ICA) aneurysm. Because of the aneurysm configuration, the authors decided to delay surgery and instead undertook serial imaging studies of the aneurysm. The patient remained alert but developed acute bilateral deafness on Day 7. Audiological examination and auditory brainstem responses suggested that the hearing disturbance was cortical in origin. Three-dimensional computed tomography (CT) angiography showed severe vasospasm in the right middle cerebral artery (MCA) and moderate vasospasm in the left ICA and MCA. Three-tesla magnetic resonance (MR) imaging was performed 2 days after the onset of symptoms. Diffusion-weighted and T2-weighted MR images showed an acute infarction in the right insular cortex caused by vasospasm. Perfusion-weighted MR imaging, particularly mean transit time mapping, revealed hypoperfusion in both temporal lobes including the auditory cortex and right auditory radiation. The vasospasm was treated with induction of mild hypertension and hypervolemia. Follow-up MR images, 3D CT angiograms, and audiometry performed 2 weeks after the first examination showed recovery of vasospasm and resolution of perfusion abnormality and hearing disturbance. On Day 26, the aneurysm was successfully occluded with clips and the patient was discharged with no deficits. To the authors' knowledge, this is the first reported case of reversible cortical auditory dysfunction purely due to bilateral cerebral vasospasm detected using perfusion MR imaging after SAH. |
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Authors:
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Sadaharu Tabuchi; Mitsutoshi Kadowaki; Takashi Watanabe |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Journal of neurosurgery Volume: 107 ISSN: 0022-3085 ISO Abbreviation: J. Neurosurg. Publication Date: 2007 Jul |
Date Detail:
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Created Date: 2007-07-20 Completed Date: 2007-08-10 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0253357 Medline TA: J Neurosurg Country: United States |
Other Details:
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Languages: eng Pagination: 161-4 Citation Subset: AIM; IM |
Affiliation:
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Department of Neurosurgery, Institute of Neurological Sciences, Tottori University School of Medicine, Yonago, Japan. stabuchi@grape.med.tottori-u.ac.jp |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aneurysm, Ruptured
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complications*,
diagnosis,
pathology Audiometry, Pure-Tone Cerebral Cortex / pathology*, physiopathology* Female Hearing Loss, Central / diagnosis, etiology*, physiopathology* Humans Imaging, Three-Dimensional Intracranial Aneurysm / complications*, diagnosis, pathology Magnetic Resonance Angiography / methods* Middle Aged Severity of Illness Index Subarachnoid Hemorrhage / complications*, diagnosis, pathology Tomography, X-Ray Computed Vasospasm, Intracranial / complications*, diagnosis, pathology |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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