Department of Internal Medicine, Hualien Armed Forces General Hospital, Hualien, Taiwan.
J Clin Neurosci. 2013 Jan;20(1):177-9. doi: 10.1016/j.jocn.2012.01.043. Epub 2012 Sep 16.
We report a patient who presented with an acute-onset transient vertigo and unsteady gait with bilateral hearing loss. Brain MRI revealed a critical basilar artery (BA) stenosis at the lower pons and infarction in various areas on both sides in the territories of the posterior inferior cerebellar arteries (PICA). Further, we could not visualize the right anterior inferior cerebellar artery (AICA). The bilateral hearing loss may be ascribed to stroke due to the critical BA stenosis, causing hypoperfusion injury extending from the PICA to the AICA on both sides. Local intra-arterial thrombolytic therapy with the administration of 1×10(6) IU of urokinase aided partial recanalization of the BA, after which the right AICA reappeared. The neurological function of the patient recovered to normal, and no hemorrhagic complications were observed. Therefore, practitioners should be alert when treating patients with acute bilateral hearing loss, which may be related to an underlying catastrophic stroke.
我们报告了一例患者，其表现为突发性短暂眩晕和双侧听力损失伴步态不稳。脑部 MRI 显示在桥下部的基底动脉（BA）严重狭窄，并在小脑后下动脉（PICA）供血区域的双侧出现梗塞。此外，我们无法观察到右侧小脑前下动脉（AICA）。双侧听力损失可能归因于由于 BA 严重狭窄导致的中风，引起从 PICA 到双侧 AICA 的低灌注损伤。局部动脉内溶栓治疗，给予 1×10(6)IU 的尿激酶，有助于 BA 的部分再通，此后右侧 AICA 再次出现。患者的神经功能恢复正常，未观察到出血并发症。因此，当治疗急性双侧听力损失的患者时，临床医生应保持警惕，因为这可能与潜在的灾难性中风有关。
