TY - JOUR
T1 - Fluctuating hearing loss secondary to spontaneous intracranial hypotension
T2 - A case report and review of the literature
AU - Cahal, Michal
AU - Roth, Jonathan
AU - Ungar, Omer J.
AU - Brinjikji, Waleed
N1 - Publisher Copyright:
© The Author(s) 2023.
PY - 2023
Y1 - 2023
N2 - Objective: Fluctuating sensorineural hearing loss (SNHL) has multiple etiologies, most commonly Ménière's disease (MD), recurrent sudden SNHL, and autoimmune inner ear disorders. Fluctuating SNHL has rarely been described as a symptom of spontaneous intracranial hypotension (SIH). Patient: A 39-year-old previously healthy female presented with “Ménière's like” symptoms responsive to steroid treatment, which worsened during the day and improved in the supine position. Conservative treatment for MD consisting of low salt and caffeine diet and betahistine medication yielded no improvement. Secondary revision of brain imaging scans showed signs indicative of SIH, and a spinal cerebrospinal fluid leak was ultimately found and treated by a novel technique of transvenous fistula embolization by means of Onyx® glue, leading to gradual clinical improvement and near-complete resolution of symptoms. Conclusion: SIH should be considered as part of the differential diagnosis of fluctuating SNHL. Clinical and radiological features should be known and sought. We suspect that early diagnosis and treatment can lead to cure and prevent permanent auditory damage.
AB - Objective: Fluctuating sensorineural hearing loss (SNHL) has multiple etiologies, most commonly Ménière's disease (MD), recurrent sudden SNHL, and autoimmune inner ear disorders. Fluctuating SNHL has rarely been described as a symptom of spontaneous intracranial hypotension (SIH). Patient: A 39-year-old previously healthy female presented with “Ménière's like” symptoms responsive to steroid treatment, which worsened during the day and improved in the supine position. Conservative treatment for MD consisting of low salt and caffeine diet and betahistine medication yielded no improvement. Secondary revision of brain imaging scans showed signs indicative of SIH, and a spinal cerebrospinal fluid leak was ultimately found and treated by a novel technique of transvenous fistula embolization by means of Onyx® glue, leading to gradual clinical improvement and near-complete resolution of symptoms. Conclusion: SIH should be considered as part of the differential diagnosis of fluctuating SNHL. Clinical and radiological features should be known and sought. We suspect that early diagnosis and treatment can lead to cure and prevent permanent auditory damage.
KW - CSF leaks
KW - Fluctuating hearing loss
KW - Ménière's disease
KW - intracranial hypotension
KW - vertigo
UR - http://www.scopus.com/inward/record.url?scp=85180846805&partnerID=8YFLogxK
U2 - 10.1177/15910199231221863
DO - 10.1177/15910199231221863
M3 - ???researchoutput.researchoutputtypes.contributiontojournal.article???
C2 - 38146166
AN - SCOPUS:85180846805
SN - 1591-0199
JO - Interventional Neuroradiology
JF - Interventional Neuroradiology
ER -