[Cortical deafness following bilateral hypertensive putaminal hemorrhage]

A case of cortical deafness is reported, which was caused by two episodes of bilateral hypertensive putaminal hemorrhage. Such a case has not appeared in literature up to this time. The patient was a right-handed, 69-year-old man, admitted to us after the stroke with right hemiparesis and disturbance of consciousness. CT scans showed right putaminal hemorrhage. After recovery of consciousness, the patient complained of hearing difficulty of the right ear. The right hemiparesis improved and he was followed ambulatorily after two months hospitalization. He returned to his work and was able to drive a car. His hearing difficulty of the right ear progressed and became stone deaf six months after onset of the initial stroke. Two years after the first stroke, he was attacked by the second stroke with left hemiparesis. CT scans showed left putaminal hemorrhage larger than the previous one in the right. When the patient recovered consciousness, he complained of total deafness. Audiometry test showed that hearing was lost completely to both high and low notes, and there was absence of bone conduction bilaterally. Auditory brain stem response test revealed normal pattern from wave I through wave V bilaterally. Middle latency response showed normal component Po on the right ear and it was absent on the left. The component Pa was not identified on both ears. He showed skill and reliance on lip reading two years after the onset of the complete deafness. Now he can speak fluently and communicate with lip reading and written language, although no improvement of the complete deafness being noticed.(ABSTRACT TRUNCATED AT 250 WORDS)