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KMID : 0911820180190020061
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Korean Journal of Headache
2018 Volume.19 No. 2 p.61 ~ p.63
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A Case of Intracranial Hypotension and Unilateral Positional Hearing Impairment with MRI Findings
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Bae Dae-Woong
Han Si-Ryung
An Jae-Young
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Abstract
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We present intracranial hypotension as a treatable cause of positional hearing loss and headache. A 27-year-old woman presented with orthostatic headache, orthostatic left ear fullness and orthostatic left hearing impairment. Brain magnetic resonance imaging and myelography demonstrated venous engorgement in the left internal acoustic canal and cerebrospinal fluid leakage into the cervical vertebrae. Pure-tone audiometry revealed left side low-frequency hearing impairment only in standing position. The patient was diagnosed with intracranial hypotension and treated with lumbar autologous epidural blood punch, showing dramatic improvement of her symptoms. Remarkably, this case showed ipsilateral venous engorgement in the internal acoustic canal with unilateral positional hearing impairment. Intracranial hypotension can be a treatable cause of unilateral neuro-otological symptoms. Also, pure-tone audiometry was useful for detecting positional hearing impairment and evaluating the therapeutic effect in intracranial hypotension. Additionally, lumbar autologous epidural blood patch was effective in the treatment of intracranial hypotension with orthostatic unilateral ear symptoms.
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KEYWORD
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Intracranial hypotension, Hearing impairment, Venous engorgement
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