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Intralabyrinthine hemorrhage

Intralabyrinthine hemorrhage is bleeding within the labyrinth of the inner ear and is a rare cause of sudden onset sensorineural hearing loss and vertigo 1

The incidence of intralabyrinthine hemorrhage is not known, and may be underdiagnosed due to its rarity and difficulty to diagnose without magnetic resonance imaging. It is associated with hematological disorders such as coagulopathies, patients on anticoagulants 2,3, and sickle cell disease 4,  as well as secondary to trauma, tumors or inflammation 1.

Presenting features primarily include sudden onset of:

The inner ear comprises both bony and membranous labyrinths containing the cochlea and vestibular system, respectively responsible for hearing and balance. Hemorrhage in these structures may disturb these fluid-filled spaces interfering with the mechanisms of hearing and balance.

MRI is the imaging modality of choice and is most sensitive for the diagnosis of intralabyrinthine hemorrhage.

T1-weighted imaging shows hyperintensity in the area of the cochlea/vestibular apparatus due to the presence of methemoglobin from blood 1,5.

Treatment largely consists of management of the underlying condition (e.g. correction of coagulopathy) 1. While oral and intratympanic steroid injection have shown some success, treatment is controversial and most therapies show no benefit over conservative management 5.

Article information

rID: 74335
System: Head & Neck
Tag: cases
Synonyms or Alternate Spellings:
  • Labyrinthine hemorrhage
  • Intralabyrinthine hemorrhage

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Cases and figures

  • Case 1
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