Department of Neurology, Keimyung University School of Medicine, Daegu, Republic of Korea.
J Neurol Sci. 2012 Feb 15;313(1-2):153-9. doi: 10.1016/j.jns.2011.08.039. Epub 2011 Oct 13.
Acute audiovestibular loss is a common neurotological condition that is characterized by sudden onset of severe prolonged (lasting days) vertigo and hearing loss and is diagnosed by the presence of canal paresis to caloric stimulation and sensorineural hearing loss on pure tone audiogram. Before 2000, papers on anterior inferior cerebellar artery (AICA) territory infarction focused mostly on associated brainstem and cerebellar findings, without a detailed description of neurotological findings. Since 2000, several reports have demonstrated that acute audiovestibular loss is an important sign for the diagnosis of AICA territory infarction. To date, at least eight subgroups of AICA infarction have been identified according to the pattern of neurotological presentations, among which the most common pattern of audiovestibular dysfunction is the combined loss of auditory and vestibular functions. Because audiovestibular loss may occur in isolation before ponto-cerebellar infarction involving AICA distribution, audiovestibular loss may serve as a window to prevent the progression of acute audiovestibular loss into more widespread areas of infarction in posterior circulation (mainly in the AICA territory). Clinician should keep in mind that acute audiovestibular loss may herald impending AICA territory infarction, especially when patients had basilar artery occlusive disease presumably close to the origin of the AICA on brain MRA, even if other central signs are absent and MRI does not demonstrate acute infarction.
急性听觉前庭损失是一种常见的神经耳科学病症，其特征为突发性、严重且持久（持续数天）的眩晕和听力损失，通过冷刺激试验出现管麻痹和纯音听力图上的感觉神经性听力损失来诊断。在 2000 年之前，关于小脑前下动脉（AICA）区域梗死的论文主要集中在相关的脑干和小脑发现上，而没有详细描述神经耳科学发现。自 2000 年以来，有几项报告表明，急性听觉前庭损失是 AICA 区域梗死的重要诊断标志。迄今为止，根据神经耳科学表现的模式，已经确定了至少 8 个 AICA 梗死亚组，其中听觉和前庭功能联合丧失是最常见的听觉前庭功能障碍模式。由于在涉及 AICA 分布的脑桥小脑梗死之前，孤立的听觉前庭损失可能发生，因此听觉前庭损失可能成为防止急性听觉前庭损失向后循环（主要在 AICA 区域）更广泛梗死区域进展的窗口。临床医生应牢记，急性听觉前庭损失可能预示着即将发生的 AICA 区域梗死，尤其是当患者存在基底动脉闭塞性疾病，并且在脑 MRA 上推测接近 AICA 的起源时，即使没有其他中央症状，MRI 也没有显示急性梗死。
