Bilateral sudden profound hearing loss and vertigo as a unique manifestation of bilateral symmetric inferior pontine infarctions.
OBJECTIVE
We present a case of sudden bilateral profound deafness and vertigo, without any accompanying neurologic signs, secondary to bilateral infarctions of the cochlear and vestibular nuclei.


METHODS
Vertigo, vomiting, tinnitus, and bilateral profound deafness suddenly developed in a 65-year-old woman without any accompanying neurologic signs. In particular, she did not present dysarthria, numbness, cranial nerve palsies, or visual or cerebellar signs.


RESULTS
Magnetic resonance imaging of the brain revealed 2 fresh infarctions of 8 to 10 mm symmetrically localized in the posterolateral bulbopontine junction. Angiography revealed a complete occlusion of the basilar artery, with a well-represented backward flow of its distal portion from the carotid artery via posterior communicating arteries. Excluding a transient ischemic attack that occurred 16 days after the acute episode, the patient had had no other neurologic events at 8 months of follow-up.


CONCLUSIONS
Acute vertigo and sudden deafness in a patient with known cerebrovascular occlusive disease may represent the warning signs of an impending brain stem or cerebellar infarction, even when other neurologic signs are absent. These events are fortunately very rare, but should be considered by clinicians who see patients with vertigo.
Bovo
Roberto
R
Department of Audiology, Ferrara University, Ferrara, Italy.
Ortore
Rocco
R
Ciorba
Andrea
A
Berto
Anna
A
Martini
Alessandro
A
D000368:Aged; D002533:Cerebral Angiography; D002544:Cerebral Infarction / Q000150:complications / Q000175:diagnosis*; D002560:Cerebrovascular Circulation / Q000502:physiology; D003937:Diagnosis, Differential; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D011149:Pons / Q000098:blood supply / Q000000981:diagnostic imaging / Q000473:pathology*; D012720:Severity of Illness Index; D014717:Vertigo / Q000175:diagnosis / Q000209:etiology*