A Case of Cortical Deafness due to Bilateral Heschl Gyrus Infarct

Narayanan, Santhosh; Majeed, Kamran; Subramaniam, Gomathy; Narayanan, Arathi; M, Navaf K

doi:10.1155/2017/6816748

Cited by 11 publications

(5 citation statements)

References 7 publications

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“…The absent MMN confirmed above mentioned comprehension difficulties. In the literature, similar observations are described, however, the extend of abnormalities is dependent on the extent of the lesion in the cortical and subcortical parts of the brain [3,12,13]. As mentioned before, over 10 months after stroke the patient hearing improved to the level of environmental sounds and music hearing ability, however with some degree of problems with recognizing and processing the sounds.…”

Section: Discussionsupporting

confidence: 70%

Cortical Deafness Due to Ischaemic Strokes in Both Temporal Lobes

et al. 2021

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Cortical deafness is a clinical rarity whereby a patient is unresponsive to all types of sounds despite the preserved integrity of the peripheral hearing organs. In this study, we present a patient who suddenly lost his hearing following ischaemic infarcts in both temporal lobes with no other neurological deficits. The CT confirmed damage to the primary auditory cortex (Heschl's gyrus) of both hemispheres. Initially, the patient was unresponsive to all sounds, however, he regained some of the auditory abilities during 10 months follow up. Pure tone threshold improvement from complete deafness to the level of moderate hearing loss in the right ear and severe in the left was observed in pure tone audiometry. Otoacoustic emissions, auditory brainstem responses, and acoustic reflex findings showed normal results. The middle and late latency potential results confirmed objectively the improvement of the patient's hearing, however, after 10 months still, they were somewhat compromised on both sides. In speech audiometry, there was no comprehension of spoken words neither at 3 nor at 10 months. The absent mismatch negativity confirmed above mentioned comprehension deficit. The extensive auditory electrophysiological testing presented in this study contributes to the understanding of the neural and functional changes in cortical deafness. It presents the evolution of changes after ischaemic cerebrovascular event expressed as auditory evoked potentials starting from short through middle and long latency and ending with event-related potentials and supported by neuroimaging.

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Section: Discussionsupporting

confidence: 70%

Cortical Deafness Due to Ischaemic Strokes in Both Temporal Lobes

et al. 2021

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“…A total of 103 manuscripts was selected for a complete text evaluation, after which 44 were included [ 2 , 4 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 ]. The total number of patients included was 46 ( Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…The duration of the follow-up varied from 2 weeks to 15 years. A substantial part of the patients did not improve, and remained with a persistent inability to recognize any sound at all (16/34.8%) [ 2 , 8 , 12 , 15 , 16 , 17 , 18 , 19 , 29 , 33 , 34 , 35 , 37 , 43 , 46 , 48 ], while others evolved to pure word deafness (11/36.6%) [ 7 , 9 , 10 , 11 , 13 , 18 , 21 , 22 , 24 , 31 , 36 , 39 , 41 , 42 ]. Oral conversation was regained in six (20%) of the patients [ 7 , 20 , 25 , 27 , 28 , 32 , 42 , 43 ].…”

Section: Resultsmentioning

confidence: 99%

Stroke-Associated Cortical Deafness: A Systematic Review of Clinical and Radiological Characteristics

et al. 2021

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Background: Stroke is the leading cause of cortical deafness (CD), the most severe form of central hearing impairment. CD remains poorly characterized and perhaps underdiagnosed. We perform a systematic review to describe the clinical and radiological features of stroke-associated CD. Methods: PubMed and the Web of Science databases were used to identify relevant publications up to 30 June 2021 using the MeSH terms: “deafness” and “stroke”, or “hearing loss” and “stroke” or “auditory agnosia” and “stroke”. Results: We found 46 cases, caused by bilateral lesions within the central auditory pathway, mostly located within or surrounding the superior temporal lobe gyri and/or the Heschl’s gyri (30/81%). In five (13.51%) patients, CD was caused by the subcortical hemispheric and in two (0.05%) in brainstem lesions. Sensorineural hearing loss was universal. Occasionally, a misdiagnosis by peripheral or psychiatric disorders occurred. A few (20%) had clinical improvement, with a regained oral conversation or evolution to pure word deafness (36.6%). A persistent inability of oral communication occurred in 43.3%. A full recovery of conversation was restricted to patients with subcortical lesions. Conclusions: Stroke-associated CD is rare, severe and results from combinations of cortical and subcortical lesions within the central auditory pathway. The recovery of functional hearing occurs, essentially, when caused by subcortical lesions.

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“…Bilateral sudden deafness is extremely rare and is most often associated with systemic diseases, such as toxicity, infection, autoimmune or neoplastic conditions, and vascular events [ 2 ]. The vascular etiology includes vasospasms after subarachnoid hemorrhage [ 3 ], intracerebral hemorrhage [ 4 ], and ischemic infarctions [ 5 ]. Most often, patients have unilateral damage in the primary auditory cortex and later get a vascular lesion on the contralateral side causing bilateral deafness.…”

Section: Introductionmentioning

confidence: 99%

Sudden Bilateral Deafness in a Patient with Transient Ischemic Attack: A Case Report

Pihl¹,

Back²,

Iversen³

et al. 2021

Case Rep Neurol

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Sudden-onset bilateral cortical deafness is a very rare symptom of stroke, but must be recognized as stroke, as it is a treatable condition, and the treatment is highly time dependent. We report a 53-year-old man with an acute onset of complete bilateral hearing loss that gradually improved spontaneously over 4 h. The hearing loss was explained by an infarction visualized on magnetic resonance imaging, which showed a subacute temporoparietal ischemic lesion in the left cerebral hemisphere involving the insular cortex and an older infarction in the right temporoparietal region. The location of these kinds of lesions may typically not cause motor deficits, but sensory and cognitive (e.g., aphasia) symptoms, which can be challenging to recognize in a suddenly deaf patient. Taking the possible differential diagnoses into account, immediate stroke workup should always be prioritized in patients with sudden bilateral deafness, as acute revascularizing treatment is possible.

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A Case of Cortical Deafness due to Bilateral Heschl Gyrus Infarct

Cited by 11 publications

References 7 publications

Cortical Deafness Due to Ischaemic Strokes in Both Temporal Lobes

Cortical Deafness Due to Ischaemic Strokes in Both Temporal Lobes

Stroke-Associated Cortical Deafness: A Systematic Review of Clinical and Radiological Characteristics

Sudden Bilateral Deafness in a Patient with Transient Ischemic Attack: A Case Report

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