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Sandro J. Stoeckli and Andreas Böhmer

T ransient hearing decrease is a known sequela after various procedures that result in loss of cerebrospinal fluid (CSF). It has been described in patients undergoing lumbar puncture, 12 spinal anesthesia, 17, 20 myelography, 12 and different types of neurosurgical procedures. 19 To our knowledge, there exists only one report in the literature of patients with persistent hearing loss after lumbar puncture 12 and only one brief report of a patient with hearing decrease after shunt placement for hydrocephalus. 3 We present the first well-documented case of

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Steven D. Chang, Joseph Poen, Steven L. Hancock, David P. Martin and John R. Adler Jr.

-described complication that is produced by subacute or late radiation injury. 9, 23 However, acute hearing loss has not previously been reported. In this paper we describe two patients with neurofibromatosis type 2 (NF2) who developed hearing loss within 24 hours after undergoing linear accelerator (LINAC)—based radiosurgery. These patients were two of 32 patients (10 with NF2) treated from 1993 to 1997 with fractionated LINAC radiosurgery. Case Reports Case 1 History This 39-year-old woman was informed that she had NF2 at the age of 26 years when bilateral acoustic

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Orhan Barlas, Hüsameddin Gökay, M. İnan Turantan and Nermin Başerer

T he constellation of episodic vertigo, tinnitus, and fluctuating hearing loss was described as a disorder of the inner ear in 1861 by Prosper Ménière. 10 We report two patients who presented with these three classic symptoms. Audiovestibulometric assessment of these two cases were indicative of inner ear disorder. Further investigations revealed aqueductal stenosis, and shunting procedures of the cerebrospinal fluid (CSF) resulted in resolution of the symptoms of the membranous inner ear disease. Although the association of inner ear disease and

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Marie-Lise C. van Veelen-Vincent, Ernst J. Delwel, Rozemarijn Teeuw, Erkan Kurt, Dirk A. de Jong, Michel P. Brocaar, Bernard K. H. Pauw, Cees J. J. Avezaat and Bert G. A. van Zanten

A fter several patients who had undergone shunt placement for treatment of presumed NPH complained about postoperative hearing loss, a study was initiated to investigate this finding further. Preshunt and postshunt placement hearing was analyzed in patients with NPH. It has been hypothesized that changes in the CSF pressure affecting cochlear physiology may be caused by shunt insertion, and hearing disturbances after lumbar puncture have previously been described. 2, 9 Recently, Stoeckli, et al., 12 reported one case of hearing disturbances after shunt

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Vanessa J. Sammons, Erica Jacobson and John Lawson

H earing loss is not generally considered a symptom of hydrocephalus. Whereas auditory symptoms have rarely been described in cases of raised ICP, hearing loss has most commonly been associated with CSF shunting and an acute reduction in ICP. 1 , 7 This case is one of documented hearing loss apparently caused by hydrocephalus, and resolution of the hearing loss after shunt placement. Case Report History In this 13-year-old boy, acute otitis media was diagnosed after he presented with severe unilateral ear pain. He described no headache or

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Nathalie Gaspar, Arnauld Verschuur, Ghislaine Mercier, Dominique Couanet, Christian Sainte-Rose and Laurence Brugières

nerve palsy (15–30%), pyramidal syndrome (5–25%), ataxia (2–50%), or endocrine dysfunction (diabetes insipidus or early puberty, 20%) 5, 13 are less frequent, and deafness has also been less frequently described. We report on the case of a 12-year-old boy in whom a malignant pineal germ cell tumor developed with an unusual clinical presentation of severe hearing loss. Possible mechanisms of hearing impairment and the characteristics and evolution of this condition are discussed. Case Report History and Examination This previously healthy 12-year-old boy had

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Daniel J. Guillaume, Kristin Knight, Carol Marquez, Dale F. Kraemer, Dianna M. E. Bardo and Edward A. Neuwelt

T here is evidence to suggest that CSF shunting or drainage may lead to hearing loss in some patients, but data are scarce and this phenomenon is relatively unknown. Although the mechanism for this is unclear, it is thought that changes in CSF pressure can affect cochlear physiology in some patients. This can occur due to pressure changes transmitted through a patent cochlear aqueduct from the subarachnoid CSF space to the perilymph, leading to endolymphatic expansion and alteration of cochlear hydrodynamics. 6 , 8 , 9 , 12 , 16 , 18 Children undergoing

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Mayur Jayarao, Anand K. Devaiah and Lawrence S. Chin

. 5 , 12 , 13 , 17 Symptoms due to arachnoid cysts are generally secondary to mass effect, and consequently in the posterior fossa, these usually manifest as seizures, tremors, Ménière disease, lower cranial nerve deficits, and occasionally headaches secondary to hydrocephalus. 2 , 4 , 15 , 16 , 24 We report the case of a patient with a cerebellopontomedullary arachnoid cyst who initially presented with unilateral sensorineural hearing loss and tinnitus, and who subsequently experienced improvement in hearing following surgical decompression. To our knowledge

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Myoung Soo Kim, Chang Wan Oh, Dae Hee Han, O-Ki Kwon, Hee-Won Jung and Moon Hee Han

A pproximately 10 to 15% of intracranial AVFs are dural 17 and these are most commonly observed to be related to dural venous sinuses. 7 During the last decade, however, these fistulas have been discovered at rare locations such as the tentorium and skull base. 14, 18, 19 The most common clinical presentations of DAVFs are bruit, headache, and, to a lesser extent, increased intracranial pressure and intracranial hemorrhage. To our knowledge, however, no cases have been reported that include hearing loss. Between 1980 and 2000, 64 patients with DAVFs were

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Michael E. Sughrue, Rajwant Kaur, Ari J. Kane, Martin J. Rutkowski, Isaac Yang, Lawrence H. Pitts, Tarik Tihan and Andrew T. Parsa

V estibular schwannomas are histologically benign lesions with an unpredictable natural history. 11 , 18 , 20 While some tumors can remain dormant for many years without causing problems, others grow rapidly and cause hearing loss and occasionally other forms of neurological impairment. 8 , 11 , 20 Some patients with small, nongrowing tumors lose their hearing, for reasons that are not well understood. 37 Because we cannot reliably predict future hearing loss in these patients, the formal indications for treatment of VS are broad, 11 , 20 and they