Skip to main content
NCBI home page
Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 2003 Dec;74(12):1644–1648. doi: 10.1136/jnnp.74.12.1644

Auditory disturbance as a prodrome of anterior inferior cerebellar artery infarction

H Lee, Y Cho
PMCID: PMC1757416  PMID: 14638883

Abstract

Objectives: To investigate the clinical and radiological features of patients presenting with an acute auditory syndrome as a prodromal symptom of anterior inferior cerebellar artery (AICA) infarction.

Methods: 16 consecutive cases of AICA infarction diagnosed by brain magnetic resonance imaging completed a standardised audiovestibular questionnaire and underwent a neuro-otological evaluation by an experienced neuro-otologist.

Results: Five patients (31%) had an acute auditory syndrome as a prodrome of AICA infarction one to 10 days before onset of other brain stem or cerebellar symptoms. Two types of acute auditory syndrome were found: recurrent transient hearing loss with or without tinnitus (n = 3), and a single episode of prolonged hearing loss with or without tinnitus (n = 2). The episodic symptoms were brief, lasting only minutes. The tinnitus preceding the infarction was identical to the tinnitus experienced at the time of infarction. At the time of infarction, all patients developed hearing loss, tinnitus, vertigo, and ipsilateral hemiataxia. The most commonly affected site was the middle cerebellar peduncle (n = 5). Four of the five patients had incomplete hearing loss and all had absence of vestibular function to caloric stimulation on the affected side.

Conclusions: Acute auditory syndrome may be a warning sign of impending pontocerebellar infarction in the distribution of the AICA. The acute auditory syndrome preceding an AICA infarct may result from ischaemia of the inner ear or the vestibulocochlear nerve.

Full Text

The Full Text of this article is available as a PDF (232.9 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Amarenco P., Hauw J. J. Cerebellar infarction in the territory of the anterior and inferior cerebellar artery. A clinicopathological study of 20 cases. Brain. 1990 Feb;113(Pt 1):139–155. doi: 10.1093/brain/113.1.139. [DOI] [PubMed] [Google Scholar]
  2. Amarenco P., Rosengart A., DeWitt L. D., Pessin M. S., Caplan L. R. Anterior inferior cerebellar artery territory infarcts. Mechanisms and clinical features. Arch Neurol. 1993 Feb;50(2):154–161. doi: 10.1001/archneur.1993.00540020032014. [DOI] [PubMed] [Google Scholar]
  3. Baloh R. W., Honrubia V., Yee R. D., Hess K. Changes in the human vestibulo-ocular reflex after loss of peripheral sensitivity. Ann Neurol. 1984 Aug;16(2):222–228. doi: 10.1002/ana.410160209. [DOI] [PubMed] [Google Scholar]
  4. Berlit P. Isolierter Schwindel bei vertebrobasilärer Ischämie--gibt es das? HNO. 1998 Apr;46(4):296–300. doi: 10.1007/s001060050244. [DOI] [PubMed] [Google Scholar]
  5. Deplanque D., Godefroy O., Guerouaou D., Laureau E., Desaulty A. Sudden bilateral deafness: lateral inferior pontine infarction. J Neurol Neurosurg Psychiatry. 1998 Jun;64(6):817–818. doi: 10.1136/jnnp.64.6.817a. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Ferbert A., Brückmann H., Drummen R. Clinical features of proven basilar artery occlusion. Stroke. 1990 Aug;21(8):1135–1142. doi: 10.1161/01.str.21.8.1135. [DOI] [PubMed] [Google Scholar]
  7. Gomez C. R., Cruz-Flores S., Malkoff M. D., Sauer C. M., Burch C. M. Isolated vertigo as a manifestation of vertebrobasilar ischemia. Neurology. 1996 Jul;47(1):94–97. doi: 10.1212/wnl.47.1.94. [DOI] [PubMed] [Google Scholar]
  8. Grad A., Baloh R. W. Vertigo of vascular origin. Clinical and electronystagmographic features in 84 cases. Arch Neurol. 1989 Mar;46(3):281–284. doi: 10.1001/archneur.1989.00520390047014. [DOI] [PubMed] [Google Scholar]
  9. Halmagyi G. M., Cremer P. D. Assessment and treatment of dizziness. J Neurol Neurosurg Psychiatry. 2000 Feb;68(2):129–134. doi: 10.1136/jnnp.68.2.129. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Huang M. H., Huang C. C., Ryu S. J., Chu N. S. Sudden bilateral hearing impairment in vertebrobasilar occlusive disease. Stroke. 1993 Jan;24(1):132–137. doi: 10.1161/01.str.24.1.132. [DOI] [PubMed] [Google Scholar]
  11. Kimura K., Minematsu K., Yasaka M., Wada K., Yamaguchi T. The duration of symptoms in transient ischemic attack. Neurology. 1999 Mar 23;52(5):976–980. doi: 10.1212/wnl.52.5.976. [DOI] [PubMed] [Google Scholar]
  12. Lee Hyung, Sohn Sung-Il, Jung Doo-Kyo, Cho Yong-Won, Lim Jeong-Geung, Yi Sang-Doe, Lee Seong-Ryong, Sohn Chul-Ho, Baloh Robert W. Sudden deafness and anterior inferior cerebellar artery infarction. Stroke. 2002 Dec;33(12):2807–2812. doi: 10.1161/01.str.0000038692.17290.24. [DOI] [PubMed] [Google Scholar]
  13. Levine R. A., Bu-Saba N., Brown M. C. Laser-Doppler measurements and electrocochleography during ischemia of the guinea pig cochlea: implications for hearing preservation in acoustic neuroma surgery. Ann Otol Rhinol Laryngol. 1993 Feb;102(2):127–136. doi: 10.1177/000348949310200210. [DOI] [PubMed] [Google Scholar]
  14. Mazzoni A. Internal auditory artery supply to the petrous bone. Ann Otol Rhinol Laryngol. 1972 Feb;81(1):13–21. doi: 10.1177/000348947208100103. [DOI] [PubMed] [Google Scholar]
  15. Mazzoni A. Internal auditory canal arterial relations at the porus acusticus. Ann Otol Rhinol Laryngol. 1969 Aug;78(4):797–814. doi: 10.1177/000348946907800413. [DOI] [PubMed] [Google Scholar]
  16. Milandre L., Rumeau C., Sangla I., Peretti P., Khalil R. Infarction in the territory of the anterior inferior cerebellar artery: report of five cases. Neuroradiology. 1992;34(6):500–503. doi: 10.1007/BF00598960. [DOI] [PubMed] [Google Scholar]
  17. Norrving B., Magnusson M., Holtås S. Isolated acute vertigo in the elderly; vestibular or vascular disease? Acta Neurol Scand. 1995 Jan;91(1):43–48. doi: 10.1111/j.1600-0404.1995.tb05841.x. [DOI] [PubMed] [Google Scholar]
  18. Oas J. G., Baloh R. W. Vertigo and the anterior inferior cerebellar artery syndrome. Neurology. 1992 Dec;42(12):2274–2279. doi: 10.1212/wnl.42.12.2274. [DOI] [PubMed] [Google Scholar]
  19. PERLMAN H. B., KIMURA R., FERNANDEZ C. Experiments on temporary obstruction of the internal auditory artery. Laryngoscope. 1959 Jun;69(6):591–613. doi: 10.1288/00005537-195906000-00001. [DOI] [PubMed] [Google Scholar]
  20. Pessin M. S., Gorelick P. B., Kwan E. S., Caplan L. R. Basilar artery stenosis: middle and distal segments. Neurology. 1987 Nov;37(11):1742–1746. doi: 10.1212/wnl.37.11.1742. [DOI] [PubMed] [Google Scholar]
  21. Rao T. H., Libman R. B. When is isolated vertigo a harbinger of stroke? Ear Nose Throat J. 1995 Jan;74(1):33–36. [PubMed] [Google Scholar]
  22. Stefan H., Wappenschmidt J., Kiefer H. Occlusions of the basilar artery: Pathologic-anatomical and clinical findings in different occlusion types and their prognosis. Neurosurg Rev. 1981;4(1):41–52. doi: 10.1007/BF01787232. [DOI] [PubMed] [Google Scholar]
  23. Toyoda Kazunori, Hirano Teruyuki, Kumai Yasuhiro, Fujii Kenichiro, Kiritoshi Shinsuke, Ibayashi Setsuro. Bilateral deafness as a prodromal symptom of basilar artery occlusion. J Neurol Sci. 2002 Jan 15;193(2):147–150. doi: 10.1016/s0022-510x(01)00663-3. [DOI] [PubMed] [Google Scholar]
  24. Yamasoba T., Kikuchi S., Higo R. Deafness associated with vertebrobasilar insufficiency. J Neurol Sci. 2001 Jun 15;187(1-2):69–75. doi: 10.1016/s0022-510x(01)00525-1. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Neurology, Neurosurgery, and Psychiatry are provided here courtesy of BMJ Publishing Group

RESOURCES