A Case of Hearing Loss after Bilateral Putaminal Hemorrhage: A Diffusion-tensor Imaging Study

Koyama, Tetsuo; Domen, Kazuhisa

doi:10.2490/prm.20160003

Cited by 6 publications

(9 citation statements)

References 30 publications

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“…1E, F). The resulting deafness could improve gradually and be replaced by auditory agnosia in some of these patients, 5,6 while other patients remain permanently deaf, 4,8,9 as in the present case. Tinnitus after bilateral putaminal hemorrhage has not JCN been reported previously.…”

Section: E Fsupporting

confidence: 58%

Cortical Deafness and Tinnitus Following Sequential Bilateral Putaminal Hemorrhage

et al. 2020

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Dear Editor, Cortical deafness is a rare condition that is usually caused by bilateral damage to the temporal lobes. We report a case of cortical deafness and tinnitus following bilateral putaminal hemorrhage. A 44-year-old Chinese woman with hypertension was referred to our neurology department for the evaluation of hearing loss and tinnitus on June 29, 2019. She had developed right hemiplegia and dysarthria suddenly on May 1, 2017, and head CT performed at that time showed a left putaminal hemorrhage. Conservative treatment produced an almost full recovery. However, she developed sudden-onset left hemiplegia and unconsciousness on November 15, 2017, at which time head CT disclosed another intracerebral hemorrhage centered in the right putamen and extending to the right temporal lobe. She reported being unable to hear anything and had mild symmetric tinnitus after she regained consciousness by conservative treatment. Her movement function gradually returned to normal, whereas the hearing loss remained unchanged and her tinnitus worsened, which she described as the persistent roar of airplane engines. On examination she did not respond to any auditory stimuli. Her speech, writing, and reading abilities were intact. She could communicate verbally with people by lip reading. There were no other remarkable findings except for bilateral brisk deep-tendon reflexes and extensor plantar responses. Brain MRI showed encephalomalacia in T1-and T2-weighted imaging (Fig. 1A, B) and hemosiderin deposits in susceptibility-weighted imaging (Fig. 1C) that were mainly bilaterally in the putamina and in the right temporal lobe. Pure-tone audiometry showed severe bilateral sensorineural hearing loss with the absence of bone conduction (Fig. 1D). She exhibited normal distortion-product otoacoustic emissions, which suggested normal functioning of the peripheral hearing system. Brainstem auditory-evoked potentials showed normal waveforms and latencies of waves I to V, indicating functional integrity of the auditory pathways within the brainstem (Supplementary Fig. 1 in the online-only Data Supplement). She was finally diagnosed with cortical deafness and referred to rehabilitation centers. Cortical deafness is a rare condition that is usually caused by bilateral damage to the temporal lobes, and subcortical lesions have also been reported to lead to this condition. 1 The underlying etiologies include stroke, mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS) syndrome, 2 multiple sclerosis. 3 To the best of our knowledge, only six cases of cortical deafness following bilateral putaminal hemorrhage have been reported 4-9 (Supplementary Table 1 in the online-only Data Supplement). The auditory radiations travel densely from the medial geniculate body (MGB) up to the sublenticular region and radiate to auditory cortices, partly by coursing through the white matter immediately ventral to the posterior half of the putamen, and partly by penetrating the ventral and lateral portions of the posterior half of the...

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Section: E Fsupporting

confidence: 58%

Cortical Deafness and Tinnitus Following Sequential Bilateral Putaminal Hemorrhage

et al. 2020

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“…A total of 103 manuscripts was selected for a complete text evaluation, after which 44 were included [ 2 , 4 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 ]. The total number of patients included was 46 ( Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…With rare exceptions [ 20 , 25 , 31 , 32 ], CD resulted from lesions affecting the hemispheres bilaterally. In a minority of patients with hemispheric stroke [ 13 , 17 , 21 , 26 , 31 , 34 , 37 ], lesions were not in or near the superior temporal gyrus or Heschl’s gyri (6/15%). Figure 2 shows that lesions were located within or in the vicinity structures that are part of the central auditory pathway.…”

Section: Resultsmentioning

confidence: 99%

Stroke-Associated Cortical Deafness: A Systematic Review of Clinical and Radiological Characteristics

et al. 2021

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Background: Stroke is the leading cause of cortical deafness (CD), the most severe form of central hearing impairment. CD remains poorly characterized and perhaps underdiagnosed. We perform a systematic review to describe the clinical and radiological features of stroke-associated CD. Methods: PubMed and the Web of Science databases were used to identify relevant publications up to 30 June 2021 using the MeSH terms: “deafness” and “stroke”, or “hearing loss” and “stroke” or “auditory agnosia” and “stroke”. Results: We found 46 cases, caused by bilateral lesions within the central auditory pathway, mostly located within or surrounding the superior temporal lobe gyri and/or the Heschl’s gyri (30/81%). In five (13.51%) patients, CD was caused by the subcortical hemispheric and in two (0.05%) in brainstem lesions. Sensorineural hearing loss was universal. Occasionally, a misdiagnosis by peripheral or psychiatric disorders occurred. A few (20%) had clinical improvement, with a regained oral conversation or evolution to pure word deafness (36.6%). A persistent inability of oral communication occurred in 43.3%. A full recovery of conversation was restricted to patients with subcortical lesions. Conclusions: Stroke-associated CD is rare, severe and results from combinations of cortical and subcortical lesions within the central auditory pathway. The recovery of functional hearing occurs, essentially, when caused by subcortical lesions.

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“…Because acoustic radiations pass through the narrow space between the caudate nucleus and the internal capsule, several previous studies reported cortical deafness after bilateral putaminal lesions. [ 2 , 3 , 6 , 7 ]…”

Section: Discussionmentioning

confidence: 99%

“…[ 1 , 2 ] A recent case study using diffuse tension imaging (DTI) reported that a patient with bilateral putaminal hemorrhage with cortical deafness showed structural impairment in bilateral acoustic radiations. [ 3 ] However, there has been no combined DTI and resting-state fMRI (rs-fMRI) study to investigate both structural and functional disruptions of auditory networks in patients with cortical deafness following bilateral subcortical hemorrhage.…”

Section: Introductionmentioning

confidence: 99%

Alterations of functional connectivity in auditory and sensorimotor neural networks

Gwak

Park

et al. 2021

Medicine

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Rationale: Cortical deafness is a rare auditory dysfunction caused by damage to brain auditory networks. The aim was to report alterations of functional connectivity in intrinsic auditory, motor, and sensory networks in a cortical deafness patient. Patient concerns: A 41-year-old woman suffered a right putaminal hemorrhage. Eight years earlier, she had suffered a left putaminal hemorrhage and had minimal sequelae. She had quadriparesis, imbalance, hypoesthesia, and complete hearing loss. Diagnoses: She was diagnosed with cortical deafness. After 6 months, resting-state functional magnetic resonance imaging (rs-fMRI) and diffuse tensor imaging (DTI) were performed. DTI revealed that the acoustic radiation was disrupted while the corticospinal tract and somatosensory track were intact using deterministic tracking methods. Furthermore, the patient showed decreased functional connectivity between auditory and sensorimotor networks. Interventions: The patient underwent in-patient stroke rehabilitation therapy for 2 months. Outcomes: Gait function and ability for activities of daily living were improved. However, complete hearing impairment persisted in 6 months after bilateral putaminal hemorrhagic stroke. Lessons: Our case report seems to suggest that functional alterations of spontaneous neuronal activity in auditory and sensorimotor networks are related to motor and sensory impairments in a patient with cortical deafness.

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A Case of Hearing Loss after Bilateral Putaminal Hemorrhage: A Diffusion-tensor Imaging Study

Cited by 6 publications

References 30 publications

Cortical Deafness and Tinnitus Following Sequential Bilateral Putaminal Hemorrhage

Cortical Deafness and Tinnitus Following Sequential Bilateral Putaminal Hemorrhage

Stroke-Associated Cortical Deafness: A Systematic Review of Clinical and Radiological Characteristics

Alterations of functional connectivity in auditory and sensorimotor neural networks

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