An isolated vestibulocochlear symptom preceding brainstem infarction due to basilar artery occlusion.

OBJECTIVE

To describe unilateral hearing loss preceding brainstem infarction due to basilar artery occlusion.

STUDY

DESIGN

Clinical capsule report.

SETTING

University hospital.

PATIENT: A 67-year-old woman presented with unilateral acute hearing loss with dizziness as a sole prodromal manifestation of basilar artery occlusion for 2 weeks before the appearance of motor and oculomotor deficits.

INTERVENTION: Otologic examinations and magnetic resonance imaging (MRI) were performed.

RESULTS

A pure-tone audiogram showed unilateral profound sensorineural hearing loss preceding brainstem occlusion. Diffusion-weighted MR image demonstrated acute infarction around the paramedian area of the upper and middle pons, although T2-weighted MR image showed a normal brain image except for occlusion of the basilar artery.

CONCLUSION

Acute unilateral hearing loss could be a prodrome of basilar artery occlusion. Clinicians must consider this possibility, especially in patients at high risk of brainstem infarction.