Spontaneous Bilateral Ear Bleeding: A Rare Presentation of Hypertensive Emergency

Abstract

A medical emergency of a life-threatening condition known as a hypertensive emergency is marked by a sudden, severe increase in blood pressure together with dysfunction of vital organs. This case report presents a rare occurrence of hypertensive emergency in an 81-year-old woman. She presented with acute bilateral ear bleeding preceded by a transient loss of consciousness and slurred speech. Bedside otoscope examination revealed minimal blood clots in the external auditory canal (EAC) and redness over the tympanic membrane, reflecting the hemotympanum. A computed tomography (CT) scan of the brain revealed fluid within the right mastoid air cell with no evidence of intracranial haemorrhage. This case illustrates the need for proper assessment and evaluation in patients presenting with sudden onset of bilateral ear bleeding associated with other systemic complaints. Spontaneous bilateral ear bleeding associated with other neurological deficits should be identified as a hypertensive emergency, prompting tight blood pressure control in a timely manner.