title: Auditory Spatial Deficits in the Early Stage of Ischemic Cerebral Stroke.
abstract: BACKGROUND
  Clinical research, together with computed tomography/magnetic resonance imaging findings, proves that ischemic stroke (IS) that damages auditory pathways can cause hearing loss and impairment of higher auditory processes such as sound localization. The goal of the study was to find possible correlations between the IS risk factors, ischemic lesion volume and localization, neurologic status, and the sound localization capability in acute IS patients.
  
  
  METHODS
  We consecutively enrolled 61 IS patients into the study. The control group consisted of 60 healthy volunteers. All neuro-otological evaluations were performed up to 30 days from the incidence of stroke. All the subjects underwent the horizontal minimum audible angle test (HMAAT) and standard tonal and speech audiometric assessments.
  
  
  RESULTS
  HMMAT results were significantly worse in the IS patients and were present in 82.0% of the patients. There were more patients with unilateral disturbances than with bilateral ones (54.1% versus 27.9%). It was the characteristics of the ischemic lesions that correlated strongly with the sound localization deterioration, that is, their bilateral (the 90° azimuth, P = .018; the 180°, P = .002), multiple (the 45°, P = .020; the 180°, P = .007; the 225°, P = .047), and lacunar character (the 90°, P = .015; the 225°, P = .042). Differences in the types of HMAAT results were significant for lesions in the frontal and the temporal lobe (P = .018 and P = .040). In addition, worse sound localization ability was more common in patients with poor speech discrimination and the bilateral sensorineural hearing loss. We have not found statistically significant correlations for other analyzed factors such as the cortical/subcortical character of the lesions, the patients' neurologic status, and cerebrovascular risk factors.
  
  
  CONCLUSIONS
  Sound localization impairment is common in IS patients and it is the multiple, bilateral, and lacunar character of the ischemic lesions that seems to be strongly positively correlated with the disturbance of the sound localization ability.
authors.affiliation: Department of Otolaryngology, Medical University of Gdańsk, Gdańsk, Poland. Electronic address: tprzew@gumed.edu.pl.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Przewoźny
authors.affiliation: Department of Neurology, Medical University of Gdańsk, Gdańsk, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Gójska-Grymajło
authors.affiliation: Department of Neurology, Medical University of Gdańsk, Gdańsk, Poland.
authors.forename: Dariusz
authors.initials: D
authors.lastname: Gąsecki
mesh_terms: D000161:Acoustic Stimulation; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001299:Audiometry; D001308:Auditory Perceptual Disorders / Q000209:etiology*; D002545:Brain Ischemia / Q000150:complications*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D013017:Sound Localization; D013037:Spatial Behavior / Q000502:physiology*; D020521:Stroke / Q000150:complications* / Q000209:etiology*; D015898:Tomography Scanners, X-Ray Computed; D055815:Young Adult
keywords: Ischemic stroke; lacunar stroke; sound localization impairment; spatial hearing