Chronic Pachymeningitis Presenting as Asymmetric Sensorineural Hearing Loss
Autor: | Joseph L. Hegarty, Alexander L Ramirez, Robert K. Jackler, John S. Oghalai |
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Rok vydání: | 2004 |
Předmět: |
Adult
Male medicine.medical_specialty Hearing loss Hearing Loss Sensorineural AN - Acoustic neuroma Dura mater Diagnosis Differential otorhinolaryngologic diseases medicine Humans Meningitis Retrospective Studies Asymmetric sensorineural hearing loss Auditory dysfunction medicine.diagnostic_test business.industry Magnetic resonance imaging Retrospective cohort study Middle Aged medicine.disease Magnetic Resonance Imaging Sensory Systems medicine.anatomical_structure Otorhinolaryngology Chronic Disease Female Sensorineural hearing loss Neurology (clinical) Radiology medicine.symptom business |
Zdroj: | Otology & Neurotology. 25:616-621 |
ISSN: | 1531-7129 |
DOI: | 10.1097/00129492-200407000-00033 |
Popis: | Objective The objective of this study was to characterize the auditory dysfunction associated with chronic pachymeningitis (inflammation of the dura mater). Study design and setting We conducted a university-based retrospective review. Results Three patients were identified who were diagnosed with chronic pachymeningitis after being referred for asymmetric sensorineural hearing loss. All patients were found to have other neurologic symptoms and signs during careful neurotologic evaluation. Two varieties of chronic pachymeningitis exist: a hypertrophic mass lesion and a linear dural thickening. Although the hypertrophic variety could be easily detectable by noncontrast magnetic resonance imaging (MRI), the linear form is only visible with the use of gadolinium enhancement. Conclusion Chronic pachymeningitis is a rare form of sensorineural hearing loss that could portend an underlying disease of greater concern. Extensive evaluation is needed to exclude identifiable causes of chronic pachymeningitis, including infectious, neoplastic, and autoimmune diseases. Significance The clinician should be aware that the evaluation of a patient with asymmetric sensorineural hearing loss involves more than simply ruling out an acoustic neuroma. Fast-spin echo MRI techniques without the use of gadolinium contrast could miss a number of potentially treatable diseases such as chronic pachymeningitis. Patients with asymmetric sensorineural hearing loss should be carefully evaluated for other neurologic findings, and imaging with enhanced MRI is recommended. |
Databáze: | OpenAIRE |
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