Interrupted speech and MRI findings after traumatic head injury: A long-term follow-up

Abstract

Objective: Hearing loss is a common sequela of traumatic head injury (THI); the site of hearing impairment can be peripheral or central. If the injury affects the central auditory system (CANS), the individual may present with a normal pure tone audiogram, but many experience hearing difficulties in more complex sound environments. Therefore, it may be important to perform central auditory testing in THI patients. Furthermore, is the integrity of a specific area of the brain related to the results on a specific central auditory test? Study design: Fourteen subjects who had experienced THI, skull fracture and/or brain contusion (BC) four to 15 years prior to the present investigation were studied. All subjects had an initial trauma-related sensorineural hearing loss (SNHL). All subjects underwent otomicroscopy, standard audiological evaluation, central auditory testing with monaural distorted speech audiometry (interrupted speech (IS)), and MRI of the brain. Results: Eight had pathological scores on IS (Group 1) and six had normal results (Group 2). Six subjects in Group 1 had temporal lobe BCs. Four of these six subjects had a left temporal lobe BC only, one had a right and left temporal lobe BC, and one a right temporal lobe BC only. In Group 2, two had left temporal lobe BCs. In addition, five subjects had BC involving the frontal lobes, two of them in combination with a temporal lobe BC. Conclusion: The results tend to indicate that the integrity of the left temporal lobe is vital in processing the IS task. No specific localization (visualized via MRI) of a BC in the temporal lobes of subjects with pathological results on IS could be demonstrated.

Key words::

• APD
• CANS
• temporal lobe
• brain contusion

Acknowledgements

We thank Sture Hennerdal and Birger Persson, Department of Radiology, Örebro University Hospital. Our thanks also go to Inga-Stina Olsson, Agneta Palmkvist-Söderberg, Carina Wikström, Audiologic Research Centre, Örebro University Hospital and Lars Skoglund, Department of Radiology, Lindesberg County Hospital, for skilful assistance.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.