Vol.100 No.4 contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 100 No. 4 April 2007
Brainstem and Cerebellar Infarction with Acute
Sensorineural Hearing Loss and Vertigo
Shu Kikuta
(University of Tokyo)
Hidehiko Takeda, Kozo Kumakawa and Masaaki Yamane
(Toranomon Hospital)
Acute ischemic stroke in the distribution of the anterior inferior cerebellar artery (AICA) is known to be associated with vertigo, facial weakness, and gait ataxia. Few reports have carefully examined deafness associated with AICA infarction. We report a patient with vertigo and acute sensorineural hearing loss due to infarction involving the AICA.
A 77-year-old man with hypertension and angina suffered sudden hearing loss in the right ear and vertigo. Neurological examination showed that spontaneous left-beating nystagmus. Pure tone audiogram showed severe sensorineural hearing loss of 73.8 dB on the right side. Two days after the initial onset of hearing loss and vertigo, the patient complained of swallowing disturbance, dysmetria of the right limbs and diminished right-sided facial sensation. MRI revealed brainstem and cerebellar infarction, and angiography demonstrated occlusion of the basilar artery. Anticoagulation treatment was started and the hearing loss and vertigo improved steadily. Follow-up pure tone audiometry at four months showed that the hearing loss in the right ear had improved to 27.5 dB. Acute auditory syndrome may be a warning sign of impending pontocerebellar infarction in the distribution of the AICA. The acute auditory syndrome preceding an AICA infarct may result from ischemia of the inner ear. We need to be aware of vertigo and hearing loss symptoms without neurological findings, which may be symptoms of infarction involving the AICA.
Key words : acute sensorineural hearing loss, anterior inferior cerebellar artery (AICA)