Hearing loss with positional changes due to spontaneous intracranial hypotension improved with treatment; a case report

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  • 起立時に増悪する難聴が治療後に改善した特発性脳脊髄液減少症の 1 例―治療効果判定の客観的指標としての臥位および座位時聴力検査―
  • キリツジ ニ ゾウアク スル ナンチョウ ガ チリョウ ゴ ニ カイゼン シタ トクハツセイ ノウ セキズイエキ ゲンショウショウ ノ 1レイ : チリョウ コウカ ハンテイ ノ キャッカンテキ シヒョウ ト シテ ノ ガイ オヨビ ザイジ チョウリョク ケンサ

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Abstract

A 51-year-old woman was admitted to our hospital because of the right ear fullness and orthostatic headache. Based on the findings of low cerebrospinal fluid (CSF) pressure and detected images of CSF leakage by MRI myelography and radionuclide cisternography, she was diagnosed as having spontaneous intracranial hypotension (SIH). Audiograms in the supine and sitting positions showed a marked hearing loss of low-frequencies and its exacerbation after the sitting. After she was treated with bed rest, hydration and epidural blood patch, hearing loss with positional changes gradually improved. In conclusion, non-invasive examinations with audiogram in the supine and sitting positions could be useful in the diagnosis of SIH and the evaluation of therapeutic efficacy of hearing loss.

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