Case 33
History:
55 year old man with chronic hearing loss
Findings:
Axial Gradient and T2-weighted MR image, centered at the level of the pons, suggests mild hypointensity along the ventral surface of the pons, particularly on the left.
Diagnosis:
Superficial siderosis
Discussion:
Superficial siderosis is usually secondary to chronic, recurrent subarachnoid hemorrhage. Clinically manifests as progressive bilateral sensorineural hearing loss (SNHL), although ataxia and pyramidal signs are also described. It affects all ages, with men affected more often than women at a ratio of approximately 3:1.
MR imaging findings of siderosis are pathognomonic. T2-weighted and, in particular, gradient-echo susceptibility imaging reveals characteristic hypointensity along the pial surface/subarachnoid space of the brain. Frequently, there is associated cerebellar atrophy.
