gms | German Medical Science

Introduction: Intracranial hypotension results from excessive cerebrospinal fluid leakage due to spinal puncture or cerebrospinal fluid leakage after head and spinal injury. However, spontaneous intracranial hypotension resulting other than the diseases mentioned above is uncommon. Without specific causes, patients complain of orthostatic headache associated with neck stiffness, nausea and vomiting, tinnitus, dizziness and even hearing difficulty in some cases. Therefore, we analyzed the treatment effect and manifestation of hearing difficulty due to spontaneous intracranial hypotension and present this uncommon disease as a cause of hearing difficulty.

Methods: From March 2009 to February 2012, 8 patients who were diagnosed and treated with spontaneous intracranial hypotension in our hospital were subjected to study. We analyzed sex, age, initial pure tone audiometry, duration of onset to initial treatment, associated symptoms, examination method, treatment method, treatment duration, and hearing recovery.

Results: Among the 8 patients, 3 were male, 5 were female and age distribution were between 29–46 years old with mean age of 37.5 years old. Mean initial pure tone audiometry was 51.8 dB and duration of onset to initial treatment was 3.4 days. 3 patients had associated orthostatic headache, 1 patient had tinnitus, and 1 patient complained of dizziness. Mean treatment duration was 13 days and all patients showed hearing recovery to normal.

Conclusions: Hearing difficulty due to spontaneous intracranial hypotension is a rare disease, but brain MRI and radionuclide cisternography are helpful in diagnosis. In cases where intracranial hypotension is suspected, steroid therapy may bring good treatment results.

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