CASE REPORT
O hematoma intracraniano traumático (HICT) raramente se apresenta com perda auditiva, especialmente em um padrão ipsilateral. Relatamos um caso único de um homem de 65 anos que desenvolveu perda auditiva à direita dois dias após um acidente automobilístico. A tomografia computadorizada de crânio revelou um hematoma no lobo temporal direito e uma contusão cerebral no lobo temporal esquerdo. Foi realizada craniotomia, e a audição do paciente retornou completamente no pós-operatório, sem déficits neurológicos adicionais. Embora o processamento auditivo envolva ambos os hemisférios, a maioria das fibras decussa, tornando a surdez cortical decorrente de uma lesão unilateral incomum. Entretanto, a radiação acústica pode ser afetada por lesões próximas à cápsula interna e ao putâmen, o que possivelmente explica esse sintoma. Este caso sugere que pode ocorrer um controle auditivo ipsilateral dominante, que pode ser comprometido pelo HICT. Além disso, o aumento das pressões intracraniana e perilinfática causado pelo trauma pode contribuir para o prejuízo auditivo. A compreensão da base neuroanatômica desses casos pode auxiliar no reconhecimento precoce e na intervenção adequada. A perda auditiva ipsilateral deve ser considerada um sintoma potencial, embora raro, do HICT no lobo temporal, e os clínicos devem estar atentos às suas implicações em contextos de trauma.
Traumatic intracranial hematoma (tICH) rarely presents with hearing loss, especially in an ipsilateral pattern. We report a unique case of a 65-year-old male who developed right-sided hearing loss two days after a motor vehicle accident. Head CT revealed a hematoma in the right temporal lobe and a cerebral contusion in the left temporal lobe. Craniotomy was performed, and the patient’s hearing returned completely postoperatively without additional neurological deficits. While auditory processing involves both hemispheres, most fibers decussate, making cortical deafness due to a unilateral lesion unusual. However, the acoustic radiation can be affected by lesions near the internal capsule and putamen, possibly explaining this symptom. This case suggests that dominant ipsilateral auditory control may occur and can be disrupted by tICH. Additionally, elevated intracranial and perilymphatic pressures caused by trauma may further impair hearing. Understanding the neuroanatomical basis of such cases may guide early recognition and intervention. Ipsilateral hearing loss should be considered a potential, albeit rare, symptom of temporal lobe tICH, and clinicians should be aware of its implications in trauma settings.
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1Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Ngoerah Hospital, Udayana University, Bali, Indonesia.
Received Sept 15, 2025
Corrected June 10, 2026
Accepted June 10, 2026
