Auditory function in acute severe head injury

Abstract

AbstractThere are few clinical neuro‐otologic investigations of acute head injury. We obtained impedance and auditory brain stem response measures for 25 acute head‐injured patients, usually within 76 hours following injury. All patients were comatose at the time of assessment. Impedance abnormalities were found for over three‐fourths of the patients. Generally, they were associated with transient, reversible dysfunction, such as high negative middle ear pressure. The acoustic stapedius reflex, however, was seldom observed, even in patients with apparently normal middle ear function.Auditory brain stem response measures showed evidence of CNS dysfunction in 80% of the patients. Abnormalities ranged from prolonged latency and reduced amplitude of the wave V auditory brain stem response component to total absence of brain stem auditory activity. There was a relationship between auditory brain stem response findings and neurologic outcome at 1 month post assessment. Electrophysiologic auditory measures are clinically valuable in neuro‐otologic diagnosis and neurologic prognosis of acute, severe head injury.