title: Subjective hearing impairment after subarachnoid haemorrhage: Prevalence and risk factors.
abstract: BACKGROUND
  Sensorineural hearing impairment is a key symptom in patients with superficial siderosis of the central nervous system, a disease caused by chronic or intermittent haemorrhage into the subarachnoid space. We investigated the prevalence and risk factors of subjective hearing impairment after SAH.
  
  
  METHODS
  We systematically interviewed all SAH patients admitted between June 2011 and December 2014, who were able to visit the SAH outpatient clinic six to eight weeks after hospital discharge. We calculated the proportion of patients with subjective hearing impairment noticed after SAH onset, and adjusted risk ratios (aRR) with 95% confidence intervals (CI) for potential risk factors with Poisson regression.
  
  
  RESULTS
  We included 277 patients. Subjective hearing impairment was reported by 54/277 (19%) patients (aneurysmal SAH: 42/212 [20%;95%CI:15-26%]; perimesencephalic haemorrhage 8/36 [22%;95%CI:12-38%], non-aneurysmal non-perimesencephalic SAH: 4/29 [14%;95%CI:6-31%]). Hearing impairment was associated with a poor clinical condition on admission (defined as PAASH score 4-5) (aRR3.00;95%CI:1.43-6.28), aneurysm rupture at the middle cerebral artery (aRR2.72;95%CI:1.38-5.39), and moderate/severe disability 3months after ictus (aRR2.25;95%CI:1.28-3.97), but not with large amounts of extravasated blood (highest vs. lowest tertile of Hijdra score) (aRR0.77;95%CI:0.33-1.81) or endovascular treatment (aRR1.19;95%CI:0.61-2.33).
  
  
  CONCLUSIONS
  Subjective hearing impairment occurs in 1 of every 5 SAH patients. It is related to the clinical condition on admission, aneurysm rupture at the middle cerebral artery, and functional outcome, but not to the amount of subarachnoid blood or the method of aneurysm occlusion. Audiometric tests, auditory cognitive assessments, and follow-up studies are needed to determine the cause and prognosis of hearing impairment after SAH.
authors.affiliation: Brain Center Rudolf Magnus, Department of Neurology and Neurosurgery (EMV, PG, GJER, MDIV) and Center of Excellence for Rehabilitation Medicine (JMAV-M), University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Erik M
authors.initials: EM
authors.lastname: Vos
authors.affiliation: Brain Center Rudolf Magnus, Department of Neurology and Neurosurgery (EMV, PG, GJER, MDIV) and Center of Excellence for Rehabilitation Medicine (JMAV-M), University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Paut
authors.initials: P
authors.lastname: Greebe
authors.affiliation: Brain Center Rudolf Magnus, Department of Neurology and Neurosurgery (EMV, PG, GJER, MDIV) and Center of Excellence for Rehabilitation Medicine (JMAV-M), University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: J M Anne
authors.initials: JMA
authors.lastname: Visser-Meily
authors.affiliation: Brain Center Rudolf Magnus, Department of Neurology and Neurosurgery (EMV, PG, GJER, MDIV) and Center of Excellence for Rehabilitation Medicine (JMAV-M), University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Gabriel J E
authors.initials: GJE
authors.lastname: Rinkel
authors.affiliation: Brain Center Rudolf Magnus, Department of Neurology and Neurosurgery (EMV, PG, GJER, MDIV) and Center of Excellence for Rehabilitation Medicine (JMAV-M), University Medical Center Utrecht, Utrecht, The Netherlands. Electronic address: M.D.I.Vergouwen@umcutrecht.nl.
authors.forename: Mervyn D I
authors.initials: MDI
authors.lastname: Vergouwen
mesh_terms: D001307:Auditory Perception; D059026:Diagnostic Self Evaluation; D004185:Disability Evaluation; D005260:Female; D034381:Hearing Loss / Q000453:epidemiology* / Q000209:etiology* / Q000523:psychology; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013345:Subarachnoid Hemorrhage / Q000150:complications* / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy
keywords: [subarachnoid haemorrhage] [perimesencephalic haemorrhage] [aneurysm] [hearing impairment]