Basilar artery occlusion presenting as sudden bilateral deafness: a case report

Kinouchi, Takemi; Ishitani, Keisuke; Uyama, Shinichi; Miyamoto, Tadashi; Fujimoto, N.; Ueta, Hiromi

doi:10.1186/s13256-020-02574-8

Cited by 3 publications

(2 citation statements)

References 25 publications

(28 reference statements)

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“…Hence, it highlights the importance of standardized hearing assessments in clinical practice, especially in a scenario when MRI has not yet been applied (Model-2). Case reports and case series suggest that bilateral SSNHL is associated with posterior circulation infarction (33)(34)(35). However, due to the lack of a control group and the relatively small sample size, those results have been considered less convincing.…”

Section: Hearing Loss Features and Strokementioning

confidence: 99%

Early detection of stroke at the sudden sensorineural hearing loss stage

Zhong,

Li,

Liu

et al. 2023

Front. Neurol.

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Background and purposeSudden sensorineural hearing loss (SSNHL) can be a prodromal symptom of ischemic stroke, especially posterior circulation strokes in the anterior inferior cerebellar artery (AICA) area. Early diagnosis and optimal treatment for vascular SSNHL provide an opportunity to prevent more extensive area infarction. The objective of our research was to find clues that suggest stroke at the stage of isolated sudden hearing loss.MethodsWe retrospectively investigated the medical records of patients who received an initial diagnosis of sudden sensorineural hearing loss upon admission from January 2017 to December 2022 at Capital Medical University Affiliated Beijing Tiantan Hospital. Among these patients, 30 individuals who developed acute ischemic stroke during their hospital stay were enrolled as the case group. To create a control group, we matched individuals from the nonstroke idiopathic SSNHL patients to the case group in terms of age (±3 years old) at a ratio of 1:4. We collected the clinical characteristics, pure tone hearing threshold test results, and imaging information for all patients included in the study.ResultsThree models were constructed to simulate different clinical situations and to identify vascular sudden sensorineural hearing loss (SSNHL). The results revealed that patients with SSNHL who had three or more stroke risk factors, bilateral hearing loss, moderately severe to total hearing loss, and any intracranial large artery stenosis and occlusion (≥50%) were at a higher risk of developing ischemic stroke during hospitalization. Consistent with previous studies, the presence of vertigo at onset also played a significant role in the early detection of upcoming stroke.ConclusionClinicians should be alert to SSNHL patients with bilateral hearing loss, moderately severe to total hearing loss and other aforementioned features. Early pure tone audiometric hearing assessment and vascular assessment are necessary for high-risk patients with SSNHL.

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Section: Hearing Loss Features and Strokementioning

confidence: 99%

Early detection of stroke at the sudden sensorineural hearing loss stage

Zhong,

Li,

Liu

et al. 2023

Front. Neurol.

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“…[1] Case reports and case series data suggest patients with sudden deafness should be considered the possibility of vertebrobasilar occlusion, especially for the patients have risk factors for stroke, even if there was no other neurologic signs. [2][3][4] Because the early diagnosis and proper management may provide a window to prevent the progression of infarction to larger areas, misdiagnosis may result in significant morbidity and mortality. We report a patient suffered bilateral deafness as initial symptoms 6 days prior to permanent infarction.…”

Section: Introductionmentioning

confidence: 99%

Sudden bilateral deafness in a patient with vertebrobasilar artery occlusion: A case report

Zhang,

Zhao,

Zhou

et al. 2023

Medicine

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Rationale: Sudden bilateral deafness is often associated with serious systematic conditions such as neoplasms, vascular events, autoimmune diseases, infections, and iatrogenic injury, but very rarely to cerebrovascular disease. This is a rare case of sudden bilateral deafness in a patient with the vertebrobasilar artery occlusion. Patient concerns: A 46-year-old man was admitted to a local hospital for sudden bilateral deafness, the patient suffered inarticulate speech and walking unsteadily 6 days later. Diagnoses: Difusion-weighted magnetic resonance imagin demonstrated acute cerebral infarction in the pons and bilateral cerebellum; Magnetic resonance angiography showed vertebrobasilar artery occlusion. Interventions: Aspirin and clopidogrel were given for antiplatelet therapy, revascularization was obtained by endovascular treatment. Outcomes: The symptoms of dysarthria, ataxia and weakness gradually improved and were discharged 14 days after admission revascularization. After 3 months telephone followed-up the patient was self-cared. Lessons: Deafness sometimes can be an early warning sign of impending vertebrobasilar ischemic stroke. Early recognition of deafness with acute ischemic stroke should allow special management, and misdiagnosis may result in significant morbidity, or even mortality.

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Bilateral Sudden Hearing Loss Caused by Basilar Artery Dissection: A Case Report

Lee¹,

Roh²,

Lee³

et al. 2021

Res Vestib Sci

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Bilateral sudden sensorineural hearing loss (SNHL) is rare, but a possible symptom of vertebrobasilar ischemia. A 69-year-old female patient with hypertension and atrial fibrillation presented with bilateral sudden hearing loss and vertigo without other neurological symptoms. On examination, she had left-beating horizontal nystagmus with positive head impulse on the left side. Pure tone audiometry revealed severe SNHL on both sides. Brain computed tomography angiography showed a dissection in the proximal portion of the basilar artery (BA) with occlusion of the mid-BA and bilateral anterior inferior cerebellar arteries (AICA), which confirmed on transfemoral cerebral angiography (TFCA). Left common carotid angiography demonstrated retrograde blood flow into the BA and right AICA via the left posterior communicating artery. During TFCA, her right hearing loss dramatically improved. Nine days later, follow-up TFCA showed an improvement of antegrade flow of the BA and AICA. We suggest that vertebrobasilar ischemia can be suspected in patients with bilateral sudden SNHL who present with risk factors for stroke.

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Basilar artery occlusion presenting as sudden bilateral deafness: a case report

Cited by 3 publications

References 25 publications

Early detection of stroke at the sudden sensorineural hearing loss stage

Early detection of stroke at the sudden sensorineural hearing loss stage

Sudden bilateral deafness in a patient with vertebrobasilar artery occlusion: A case report

Bilateral Sudden Hearing Loss Caused by Basilar Artery Dissection: A Case Report

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