In superficial siderosis, a very slow bleed into the brain results in accumulation of iron on the surface of the brain, cranial nerves, and spinal cord. This can cause symptoms of hearing loss and imbalance that usually start between 40 and 70 years of age and progress very slowly. Audiologic and vestibular tests, and brain imaging, may help distinguish this disease from others that it may closely resemble. If a source of bleeding is identified, then this should be repaired, but often no source of bleeding is found.