title: Long-term prognosis for hearing recovery in stroke patients presenting vertigo and acute hearing loss.
abstract: OBJECTIVE
  Vertebrobasilar ischemic stroke (VBIS) can cause acute hearing loss (AHL) because the vertebrobasilar system supplies most of the auditory system including the inner ear. The aim of this study was to assess the long-term prognosis of AHL associated with VBIS.
  
  
  METHODS
  Over 12.5 years, 62 patients with AHL of a vascular cause who were followed for at least 1 year (mean, 49.2 months; SD, 24.4 months) were enrolled in this study. Quantitative audiovestibular function testing was performed during the acute (mostly within 10 days after symptom onset) and last follow-up periods in all patients.
  
  
  RESULTS
  On the last follow-up, approximately 65% (39/62) of the patients showed a partial (n=24) or complete (n=15) hearing recovery. All but 2 (97%) patients had acute vertigo and 56 (56/62, 90%) had a unilateral canal paresis to caloric stimulation on the side of the AHL. The most commonly infarcted territory on brain MRI was in the distribution of the anterior inferior cerebellar artery (55/62, 89%). Multivariable analysis showed that multiple risk factors for stroke [odds ratio (OR) 10.46, 95% confidence interval (CI) 1.72 to 13.7, p=0.011] and profound hearing loss [OR 3.92, 95% CI 1.03 to 14.97, p<0.046] predicted a poor outcome for recovery of hearing loss.
  
  
  CONCLUSIONS
  Acute hearing loss associated with posterior circulation ischemic stroke exhibits a relatively good long-term outcome. Two or more risk factors for stroke and profound hearing loss are adverse prognostic factors for recovery of hearing loss of a vascular cause.
authors.affiliation: Department of Neurology, Keimyung University School of Medicine, Daegu, Republic of Korea; Brain Research Institute, Keimyung University School of Medicine, Daegu, Republic of Korea.
authors.forename: Hyun-Ah
authors.initials: HA
authors.lastname: Kim
authors.affiliation: Department of Neurology, Keimyung University School of Medicine, Daegu, Republic of Korea.
authors.forename: Byung-Chan
authors.initials: BC
authors.lastname: Lee
authors.affiliation: Department of Neurology, Keimyung University School of Medicine, Daegu, Republic of Korea; Brain Research Institute, Keimyung University School of Medicine, Daegu, Republic of Korea.
authors.forename: Jeong-Ho
authors.initials: JH
authors.lastname: Hong
authors.affiliation: Department of Otorhinolaryngology, Keimyung University School of Medicine, Daegu, Republic of Korea.
authors.forename: Chang-Ki
authors.initials: CK
authors.lastname: Yeo
authors.affiliation: Department of Neurology, Keimyung University School of Medicine, Daegu, Republic of Korea; Brain Research Institute, Keimyung University School of Medicine, Daegu, Republic of Korea.
authors.forename: Hyon-Ah
authors.initials: HA
authors.lastname: Yi
authors.affiliation: Department of Neurology, Keimyung University School of Medicine, Daegu, Republic of Korea; Brain Research Institute, Keimyung University School of Medicine, Daegu, Republic of Korea. Electronic address: hlee@dsmc.or.kr.
authors.forename: Hyung
authors.initials: H
authors.lastname: Lee
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D034381:Hearing Loss / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D020127:Recovery of Function / Q000502:physiology*; D020521:Stroke / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D013997:Time Factors; D014717:Vertigo / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology
keywords: Hearing loss; Long-term outcome; Prognostic factor; Stroke; Vertebrobasilar territory; Vertigo