[Labyrinthine hemorrhage caused by anticoagulant therapy].
OBJECTIVE
To report a case of labyrinthine hemorrhage with a sudden sensorineural hearing loss and vertigo. This is a rare mechanism of inner ear damage, which may be considered in patients with anticoagulant therapy.


METHODS
We report a case of sudden sensorineural hearing loss and vertigo in a 73-year-old male on anticoagulant therapy for arrhythmia. An audiovestibular and imaging work-up was performed.


RESULTS
Audiometry showed a left profound hearing loss. Videonystagmography demonstrated a left labyrinthine deficit. Hemostasis assessment showed an INR at 7.5 MR imaging evidenced a high intralabyrinthine signal on T1-weighted images without gadolinium and on FLAIR T2-weighted images, suggesting labyrinthine hemorrhage. At clinical follow-up the vertigo regressed but the hearing function was not recovered.


CONCLUSIONS
Labyrinthine hemorrhage should be evoked in the event of sudden sensorineural hearing loss in patients with anticoagulant therapy. MRI is a useful diagnostic tool in this case.
Vellin
J-Fr
JF
Service d'ORL et Chirurgie Cervico-Faciale, Hôpital Beaujon, AP-HP, 100 Bd. du Général Leclerc, F-92118, Clichy cedex, France.
Bozorg Grayeli
A
A
Cyna-Gorse
Fr
F
Refass
A
A
Bouccara
D
D
Sterkers
O
O
D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects*; D007758:Ear, Inner / Q000473:pathology; D003639:Hearing Loss, Sudden / Q000209:etiology; D006470:Hemorrhage / Q000139:chemically induced* / Q000175:diagnosis; D006801:Humans; D007759:Labyrinth Diseases / Q000139:chemically induced* / Q000175:diagnosis; D008279:Magnetic Resonance Imaging; D008297:Male; D014717:Vertigo / Q000209:etiology
D000925:Anticoagulants