Bilateral Acute Low-Tone Sensorineural Hearing Loss in Spontaneous Intracranial Hypotension-A Case Report

Abstract

A 38-year-old female suffering from sudden onset of postural severe headache and neck stiffness complained bilateral tinnitus in a few days later, which were relieved by lying flat. Her audiogram showed a bilateral low-tone sensorineural hearing loss (BLSHL) manifested by 15-20dB improvement in the supine position. Lumbar puncture revealed an opening pressure of 0mmH₂O and MRI showed a diffuse pachymeningeal gadolinium enhancement with a decrease in the size of the ventricles, indicating spontaneous intracranial hypotension (SIH). BLSHL in SIH may manifest a relative endolymphatic hydrops as a result of a loss of perilymphatic fluid through the cochlear aqueduct and a compression of the 8th cranial nerve by the downward displacement of brain in the upright position following CSF leak.