Inner ear dysfunction due to vertebrobasilar ischemic stroke.

Because the blood supply to the inner ear originates from the vertebrobasilar system, vertebrobasilar ischemic stroke can present with vertigo and hearing loss due to infarction of the inner ear (i.e., labyrinthine infarction). Sometimes vertigo and hearing loss are warning symptoms of impending vertebrobasilar ischemic stroke (mainly in the anterior inferior cerebellar artery territory). In this case, the magnetic resonance imaging (MRI) scan is normal and the clinician must rely on other clinical features to make the diagnosis. Here the authors review the keys to the diagnosis of vertigo and hearing loss associated with vertebrobasilar ischemic stroke.