title: Auditory hallucination in basilar occlusion: I heard it was the basilar.
abstract: Acute basilar artery occlusion is a neurological emergency. Unlike anterior circulation stroke presenting with hemiparesis, the symptoms of basilar artery occlusion are challenging to recognise in the emergency setting. Basilar artery occlusion can rarely lead to ischaemia of the auditory pathways, resulting in bizarre, positive auditory hallucinations. Here, we report two cases of basilar artery occlusion presenting with positive auditory phenomena; in both cases the auditory phenomenon resolved upon arterial recanalisation. We discuss the phenomenology of this unusual and distinctive neurological symptom. Acute auditory hallucinosis in the setting of sudden vomiting, dizziness, visual disturbance or other posterior circulation symptoms should prompt emergency imaging of the basilar artery, to avoid a potentially devastating posterior circulation stroke.
authors.affiliation: Department of Neurology, Cork University Hospital, Cork, Ireland.
authors.forename: Siew Mei
authors.initials: SM
authors.lastname: Yap
authors.affiliation: Department of Radiology, Cork University Hospital, Cork, Ireland.
authors.forename: Gerald
authors.initials: G
authors.lastname: Wyse
authors.affiliation: Department of Radiology, Addenbrooke's Cambridge NHS University Hospital, Cambridge, UK.
authors.forename: J Nicholas P
authors.initials: JN
authors.lastname: Higgins
authors.affiliation: Department of Stroke Medicine, Addenbrooke's Cambridge NHS University Hospital, Cambridge, UK.
authors.forename: Eoin
authors.initials: E
authors.lastname: O'Brien
authors.affiliation: Department of Neurology, Cork University Hospital, Cork, Ireland Department of Clinical Neuroscience, College of Medicine and Health, University College Cork, Cork, Ireland.
authors.forename: Simon
authors.initials: S
authors.lastname: Cronin
mesh_terms: D000328:Adult; D005260:Female; D006212:Hallucinations / Q000209:etiology*; D006801:Humans; D008875:Middle Aged; D013927:Thrombosis / Q000150:complications / Q000473:pathology; D014715:Vertebrobasilar Insufficiency / Q000150:complications* / Q000473:pathology
keywords: CEREBROVASCULAR DISEASE; HALLUCINATIONS; NEUROOTOLOGY