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CASE REPORT: A RARE CASE OF CEREBRAL VENOUS SINUS THROMBOSIS PRESENTING WITH UNILATERAL SENSORINEURAL HEARING LOSS

INTRODUCTION

Thrombosis of the cerebral veins and sinuses is a distinct cerebrovascular disorder that, unlike arterial stroke, most often affects young adults and children mainly females . Hearing loss is an unusual presentation of central venous sinus thrombosis. The symptoms and clinical course can be highly variable. Recently, few studies and case reports have highlighted the incidence of cerebral sinus venous thrombosis (CSVT) in association with otological symptoms such as hearing loss and tinnitus; and few even suggest these features as being prodrome of cerebral sinus venous thrombosis . CSVT in a adult male is a very rare entity and even rarer is the otological symptoms being the presenting feature. We present such a case of cerebral sinus venous thrombosis who presented with sudden onset unilateral sensorineural hearing loss and tinnitus.



Case Report:

A 31 years old non diabetic, normotensive male, occasional smoker and tobacco chewer, presented with history of tinnitus (L) & sudden onset hearing loss (L) since 25 days. Patient denied any history of otorrhoea, otalgia, aural fullness and vertigo. He gave no history of recent head trauma, acoustic trauma or exposure to ototoxic drugs.

There was no history of fever, headache, seizures and loss of consciousness, altered sensorium and weakness of any part of body, projectile vomiting, and diminution of vision. No history of use of any medication for long term.

On examination, patient was fully conscious and oriented in time, place and person with Glasgow coma scale 15/15. He was afebrile, with normal heart rate and blood pressure. There were no signs of meningitis.

Neurological and other systemic examination revealed no abnormality. Otoscopic examination revealed normal tympanic membrane bilaterally. Free field hearing and tuning fork tests revealed normal hearing in right ear and severe sensorineural hearing loss in left ear. The otoneurological examination was essentially normal.

Pure tone audiometry was done which revealed showed severe sensorineural hearing loss in left ear and normal hearing sensitivity in right ear.







Pure Tone Audiometry of patient

MRI & MRA Brain and inner ear showed Left transverse sinus, sigmoid sinus and Internal Jugular Vein thrombosis. The cochlea, semicircular canals, auditory nerves, internal acoustic meatus posterior cranial fossa and cerebellopontine angle were normal on both sides.





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