Sunami Eiko, Nagayama Hiroshi, Yamazaki Mineo, Katsumata Toshiya, Katayama Yasuo
The Second Department of Internal Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo ku, Tokyo 113 8603, Japan.
No To Shinkei. 2006 Sep;58(9):791-5.
A 56-year old male presented with a sudden onset of bilateral hearing difficulty. He complained of dizziness and gait disturbance at the onset and subsequently developed bilateral hearing loss and tinnitus. Brain MRI revealed multiple infarcts in bilateral middle cerebellar peduncles, bilateral cerebellar hemispheres and the right cerebral peduncle. Three dimentional computed tomography angiography (3D-CTA) showed severe stenosis of bilateral vertebral arteries. Infarcts were located in the border zone between anterior inferior cerebellar artery (AICA) and superior cerebellar artery (SCA), suggesting hemodynamic infarctions. Auditory brain stem responses (ABR) were recorded three times. The initial ABR demonstrated all waves except for wave I on day 14. Wave I on the left was normal, while wave I peak latency on the right was prolonged. On day 61, all waves were recorded, although peak latencies of waves III to V and interpeak intervals of the wave I to III on the right side were prolonged. Involvements of the cochlear nerve and pontine auditory pathway were suggested from the ABR abnormalities in this case.
一名56岁男性突发双侧听力困难。起病时他诉说头晕和步态障碍，随后出现双侧听力丧失和耳鸣。脑部磁共振成像（MRI）显示双侧小脑中脚、双侧小脑半球及右侧大脑脚有多处梗死灶。三维计算机断层血管造影（3D-CTA）显示双侧椎动脉严重狭窄。梗死灶位于小脑前下动脉（AICA）和小脑上动脉（SCA）之间的边缘带，提示为血流动力学梗死。听觉脑干反应（ABR）记录了3次。初始ABR在第14天时除I波外所有波均有显示。左侧I波正常，而右侧I波峰潜伏期延长。在第61天时，所有波均被记录到，尽管右侧III至V波的峰潜伏期及I至III波的峰间间期延长。该病例中ABR异常提示蜗神经和脑桥听觉通路受累。
