전구증상으로 급성 내이기능 장애가 발현된 척추동맥 협착에 의한 일과성 허혈발작
A Case of Acute Inner Ear Dysfunction as a Prodrome of Transient Ischemic Attack Caused by Vertebral Artery Stenosis
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A sudden hearing loss with vertigo may originate from vascular insufficiency and sometimes presents as an initial manifestation of posterior brain circulation infarction. However, it is unusual that sudden hearing loss and vertigo present as a prodrome of transient ischemic attack. Here we describe the case of a 54-year-old male patient with hypertension who presented with a sudden onset of hearing loss in his right ear and recurrent severe, whirling type dizziness without associated neurological signs or symptoms. The diffusion-weighted magnetic resonance imaging (MRI) was normal on initial presentation. Ten days later, however, the patient developed dysarthria. A follow-up MRI including the diffusion-weighted images was normal but cerebral angiography showed severe narrowing of right vertebral artery. Transient ischemic attack caused by vertebrobasilar artery stenosis should be considered in sudden hearing loss and vertigo, especially patients with vascular risk factors, even though images of brain MRI are normal. Korean J Otorhinolaryngol-Head Neck Surg 2016;59(1):58-63
Abstract
A sudden hearing loss with vertigo may originate from vascular insufficiency and sometimes presents as an initial manifestation of posterior brain circulation infarction. However, it is unusual that sudden hearing loss and vertigo present as a prodrome of transient ischemic attack. Here we describe the case of a 54-year-old male patient with hypertension who presented with a sudden onset of hearing loss in his right ear and recurrent severe, whirling type dizziness without associated neurological signs or symptoms. The diffusion-weighted magnetic resonance imaging (MRI) was normal on initial presentation. Ten days later, however, the patient developed dysarthria. A follow-up MRI including the diffusion-weighted images was normal but cerebral angiography showed severe narrowing of right vertebral artery. Transient ischemic attack caused by vertebrobasilar artery stenosis should be considered in sudden hearing loss and vertigo, especially patients with vascular risk factors, even though images of brain MRI are normal. Korean J Otorhinolaryngol-Head Neck Surg 2016;59(1):58-63
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