title: Acute bilateral hearing loss as a "worsening sign" in a patient with critical basilar artery stenosis.
abstract: We report a patient who presented with an acute-onset transient vertigo and unsteady gait with bilateral hearing loss. Brain MRI revealed a critical basilar artery (BA) stenosis at the lower pons and infarction in various areas on both sides in the territories of the posterior inferior cerebellar arteries (PICA). Further, we could not visualize the right anterior inferior cerebellar artery (AICA). The bilateral hearing loss may be ascribed to stroke due to the critical BA stenosis, causing hypoperfusion injury extending from the PICA to the AICA on both sides. Local intra-arterial thrombolytic therapy with the administration of 1×10(6) IU of urokinase aided partial recanalization of the BA, after which the right AICA reappeared. The neurological function of the patient recovered to normal, and no hemorrhagic complications were observed. Therefore, practitioners should be alert when treating patients with acute bilateral hearing loss, which may be related to an underlying catastrophic stroke.
authors.affiliation: Department of Internal Medicine, Hualien Armed Forces General Hospital, Hualien, Taiwan.
authors.forename: Chun-I
authors.initials: CI
authors.lastname: Chiang
authors.forename: Chung-Hsing
authors.initials: CH
authors.lastname: Chou
authors.forename: Chun-Jen
authors.initials: CJ
authors.lastname: Hsueh
authors.forename: Chun-An
authors.initials: CA
authors.lastname: Cheng
authors.forename: Giia-Sheun
authors.initials: GS
authors.lastname: Peng
mesh_terms: D018450:Disease Progression; D007839:Functional Laterality; D006312:Hearing Loss, Bilateral / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D014715:Vertebrobasilar Insufficiency / Q000150:complications* / Q000175:diagnosis