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Case Report
- Bilateral Sudden Hearing Loss Caused by Basilar Artery Dissection: A Case Report
- Ho Byung Lee, Jieun Roh, Hyun Min Lee, Jae-Hwan Choi
- Res Vestib Sci. 2021;20(4):151-155. Published online December 15, 2021
- DOI: https://doi.org/10.21790/rvs.2021.20.4.151
- 2,623 View
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Abstract
PDF - 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.
Original Article
- Vertebrobasilar Pathology of Acute Isolated Vertigo: A Case-Control Study
- Hee Joon Bae, Byung Kun Kim
- J Korean Bal Soc. 2002;1(2):245-252.
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Abstract
PDF
- Background
: Till now, several studies advocated the vascular etiology as a cause of acute isolated vertigo without relevant lesions on magnetic resonance imaging (MRI). However, most of them were case series and ,even in a few case-control studies, inclusion criteria were obscure and vascular risk factors were not considered. Objectives: To investigate the clinical significance of vertebrobasilar artery (VBA) pathology in acute isolated vertigo without relevant lesions on MRI. Methods : 84 patients (26 male, 59 female; 62.5±10.2 years) with acute isolated vertigo who had no lesions on MRI were gathered. Seventy nine controls (30 male, 49 female; 58.4±10.1 years) consisted of subjects with clinically definite BPPV, epilepsy, tension headache, or lacunar infarction. All the subjects underwent MRI and magnetic resonance angiography (MRA). The vascular pathology of VBA and anterior circulation were examined and graded by the findings of MRA. Focal stenosis more than 50%, non- or faint-visualization, or dolichoectasia of VBA were regarded as significant. Risk factors of atherosclerosis were investigated and the severity of small vessel disease on MRI were ranked. Results : Significant vascular pathology of VBA was found more frequently in patients with acute isolated vertigo (32.1%) than in controls (16.5%) (p<0.05). Among the risk factors of atherosclerosis, hypertension was more common in patients (44.0%) than in controls (29.1%) (p<0.05) and the others were not different between two groups. Significant vascular pathology of anterior circulation and SVD were not different, too (P>0.05). Multivariate analysis including all the possible variables investigated confirmed the significant correlation between VBA pathology and acute isolated vertigo in our subjects (p<0.05). Conclusion : This study demonstrates that there is a signficant correlation between VBA pathology and acute isolated vertigo without lesions on MRI. It can support the importance of VBA pathology as a a cause of acute isolated vertigo.
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