J Cerebrovasc Endovasc Neurosurg.  2013 Sep;15(3):225-228. 10.7461/jcen.2013.15.3.225.

Vertebrobasilar Occlusion Presenting as Sudden Isolated Bilateral Sensorineural Hearing Loss: Case Report

• Kim E
• Son MK
• Kang CK
• Lee YB

• KMID: 1491443
• DOI: http://doi.org/10.7461/jcen.2013.15.3.225

Abstract

Isolated bilateral deafness is a rare but possible symptom of vertebrobasilar ischemia, primarily due to occlusion of the anterior inferior cerebellar arteries or their branch, the internal auditory artery. We reported on uncommon case of sudden bilateral sensorineural hearing loss without typical neurological symptoms resulting from vertebrobasilar ischemia. We performed the available examinations, including otoscopy, laboratory tests, and pure tone audiogram, however we were not able to identify the cause of bilateral sensorineural hearing loss. Brain magnetic resonance image showed the cerebellar infarction of the posterior inferior cerebellar artery territory. Brain magnetic resonance angiography showed bilateral vertebral and basilar artery occlusion. We suggest vertebrobasilar ischemia as a cause of sudden isolated deafness.

Keyword

Vertebro-basilar ischemia; Sensori-neural hearing loss; Cerebral infarction; Sudden hearing loss; Magnetic resonance imaging; Audiometry

MeSH Terms

Arteries
Audiometry
Basilar Artery
Brain
Cerebral Infarction
Deafness
Hearing
Hearing Loss, Sensorineural
Hearing Loss, Sudden
Infarction
Magnetic Resonance Angiography
Magnetic Resonance Imaging
Magnetics
Magnets
Otoscopy
Vertebrobasilar Insufficiency

Figure

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  Fig. 1 Initial pure tone audiometry (A) shows bilateral sensorineural hearing loss and follow-up pure tone audiometry (B) 2 weeks after symptom onset reveals improvement of hearing.

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  Fig. 2 Brain magnetic resonance image and magnetic resonance angiography show multifocal bilateral cerebellar infarction in the area of the bilateral posterior inferior cerebellar artery (white arrow) and bilateral vertebral and basilar artery occlusion (Black arrow), respectively.

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  Fig. 3 Transfemoral cerebral angiography shows occlusion of the right proximal vertebral artery and basilar artery (A) and severe stenosis of the left distal vertebral artery (B). Both intracranial artery angiograms show leptomeningeal anastomoses between middle cerebral artery and posterior cerebral artery; the reversed flow to the basilar artery and its branches through the posterior communicating artery (C, D).

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