Sudden Bilateral Hearing Loss Is a Neurovascular Emergency
- 1Department of Neurology University of Alabama at Birmingham Birmingham Alabama USA uab.edu
Abstract
Sudden bilateral hearing loss is not commonly encountered by neurologists. Many first‐line providers commonly label hearing loss as peripheral in origin, leading to misdiagnosis and delayed treatment. A 49‐year‐old female presented with sudden bilateral hearing loss and headache. Neurologic examination revealed mild right‐sided weakness, sensory loss, and ataxia. CT scan of the brain revealed left mid‐dorsal pontine intraparenchymal hemorrhage. Further testing with MRI brain and brainstem auditory evoked potentials (BAEPs) confirmed a central etiology of hearing loss. Prompt diagnosis and treatment resulted in complete resolution of hearing loss and only mild, nondisabling sensorimotor deficits at 3‐month clinic follow‐up. This case emphasizes the importance of treating sudden‐onset bilateral hearing loss as a neurologic emergency until proven otherwise. We discuss the etiologies of sudden‐onset sensorineural hearing loss and carefully localize the lesion to the brainstem in this rare presentation of a pontine syndrome. We highlight common principles of BAEP testing and expected findings in patients with stroke and demyelinating lesions.
Related
- Efficacy of Defibrinogenation Therapy for Sudden Sensorineural Hearing Loss: A Systematic Review and Meta‐Analysis
- Viral Etiology of Sudden Sensorineural Hearing Loss: Historical Development and Current Evidence.
- Case Report: A potential cardiovascular safety signal during batroxobin therapy for sudden sensorineural hearing loss: a three-case series of acute myocardial infarction
- Sudden hearing loss in enlarged vestibular aqueduct syndrome: a systematic review of treatment and outcomes
- Pro-inflammatory diet association with sudden sensorineural hearing loss: a case-control study
BibTeX
@article{rehman2026sudden,
title = {{Sudden Bilateral Hearing Loss Is a Neurovascular Emergency}},
author = {Muhammad Aemaz Ur Rehman and Mohammad Aladawi and Eroboghene E. Ubogu and Felix Guerra-Castanon},
journal = {Case Reports in Neurological Medicine},
year = {2026},
month = nov,
doi = {10.1155/crnm/5892582},
url = {https://doi.org/10.1155/crnm/5892582},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Sudden Bilateral Hearing Loss Is a Neurovascular Emergency
AU - Muhammad Aemaz Ur Rehman
AU - Mohammad Aladawi
AU - Eroboghene E. Ubogu
AU - Felix Guerra-Castanon
PY - 2026
DA - 2026/11/01
JO - Case Reports in Neurological Medicine
DO - 10.1155/crnm/5892582
UR - https://doi.org/10.1155/crnm/5892582
AB - Sudden bilateral hearing loss is not commonly encountered by neurologists. Many first‐line providers commonly label hearing loss as peripheral in origin, leading to misdiagnosis and delayed treatment. A 49‐year‐old female presented with sudden bilateral hearing loss and headache. Neurologic examination revealed mild right‐sided weakness, sensory loss, and ataxia. CT scan of the brain revealed left mid‐dorsal pontine intraparenchymal hemorrhage. Further testing with MRI brain and brainstem auditory evoked potentials (BAEPs) confirmed a central etiology of hearing loss. Prompt diagnosis and treatment resulted in complete resolution of hearing loss and only mild, nondisabling sensorimotor deficits at 3‐month clinic follow‐up. This case emphasizes the importance of treating sudden‐onset bilateral hearing loss as a neurologic emergency until proven otherwise. We discuss the etiologies of sudden‐onset sensorineural hearing loss and carefully localize the lesion to the brainstem in this rare presentation of a pontine syndrome. We highlight common principles of BAEP testing and expected findings in patients with stroke and demyelinating lesions.
SN - 2090-6668
SN - 2090-6676
ER -