Vertebrobasilar Occlusion Initially Presenting with Sudden Bilateral Hearing Loss with Vertigo

ABSTRACT

A 57-year-old man complained of sudden hearing loss and vertigo as sole initial symptoms. Pure tone audiometry revealed severe bilateral sensorineural hearing loss. Brain MRI demonstrated multiple scattered small acute infarctions in the bilateral thalami, occipital lobe, cerebellum and ventral upper pons, however, none in the level of vestibulocochlear nuclei. Cerebral angiography revealed vertebrobasilar occlusion with collateral circulation. On the seventh day of the patient's hospital stay, he developed dysarthria, dysphagia and ataxia. Five months later, his hearing loss persisted, but other neurologic deficits improved substantially.