Korean J Otorhinolaryngol-Head Neck Surg.  2016 Jan;59(1):58-63. 10.3342/kjorl-hns.2016.59.1.58.

A Case of Acute Inner Ear Dysfunction as a Prodrome of Transient Ischemic Attack Caused by Vertebral Artery Stenosis

• Kim GW
• Park JH
• Kim DH
• Kim CW

• KMID: 2277945
• DOI: http://doi.org/10.3342/kjorl-hns.2016.59.1.58

Abstract

A sudden hearing loss with vertigo may originate from vascular insufficiency and sometimes presents as an initial manifestation of posterior brain circulation infarction. However, it is unusual that sudden hearing loss and vertigo present as a prodrome of transient ischemic attack. Here we describe the case of a 54-year-old male patient with hypertension who presented with a sudden onset of hearing loss in his right ear and recurrent severe, whirling type dizziness without associated neurological signs or symptoms. The diffusion-weighted magnetic resonance imaging (MRI) was normal on initial presentation. Ten days later, however, the patient developed dysarthria. A follow-up MRI including the diffusion-weighted images was normal but cerebral angiography showed severe narrowing of right vertebral artery. Transient ischemic attack caused by vertebrobasilar artery stenosis should be considered in sudden hearing loss and vertigo, especially patients with vascular risk factors, even though images of brain MRI are normal.

Keyword

Dizziness; MRI; Transient ischemic attack; Vertebral artery

MeSH Terms

Arteries
Brain
Cerebral Angiography
Constriction, Pathologic
Dizziness
Dysarthria
Ear
Ear, Inner*
Follow-Up Studies
Hearing Loss
Hearing Loss, Sudden
Humans
Hypertension
Infarction
Ischemic Attack, Transient*
Magnetic Resonance Imaging
Male
Middle Aged
Risk Factors
Vertebral Artery*
Vertebrobasilar Insufficiency*
Vertigo