背景:突发性双侧耳聋通常与肿瘤等严重的系统性疾病有关,血管事件,自身免疫性疾病,感染,和医源性损伤,但很少到脑血管疾病。这是一例罕见的椎基底动脉闭塞患者的双侧突发性耳聋。
方法:一名46岁的男子因突发性双侧耳聋被送往当地医院,6天后,患者言语不清,行走不稳定。
方法:磁共振弥散成像显示脑桥和双侧小脑急性脑梗死;磁共振血管造影显示椎基底动脉闭塞。
方法:阿司匹林和氯吡格雷用于抗血小板治疗,通过血管内治疗获得血运重建.
结果:构音障碍的症状,共济失调和虚弱逐渐改善,入院后14天血运重建出院。经过3个月的电话随访,患者得到了自我护理。
结论:耳聋有时可能是即将发生的椎基底动脉缺血性卒中的早期预警信号。早期认识到急性缺血性卒中的耳聋应进行特殊处理,和误诊可能导致显著的发病率,甚至死亡率。
BACKGROUND: Sudden bilateral deafness is often associated with serious systematic conditions such as neoplasms, vascular events, autoimmune diseases, infections, and iatrogenic injury, but very rarely to cerebrovascular disease. This is a rare case of sudden bilateral deafness in a patient with the vertebrobasilar artery occlusion.
METHODS: A 46-year-old man was admitted to a local hospital for sudden bilateral deafness, the patient suffered inarticulate speech and walking unsteadily 6 days later.
METHODS: Difusion-weighted magnetic resonance imagin demonstrated acute cerebral infarction in the pons and bilateral cerebellum; Magnetic resonance angiography showed vertebrobasilar artery occlusion.
METHODS: Aspirin and clopidogrel were given for antiplatelet therapy, revascularization was obtained by endovascular treatment.
RESULTS: The symptoms of dysarthria, ataxia and weakness gradually improved and were discharged 14 days after admission revascularization. After 3 months telephone followed-up the patient was self-cared.
CONCLUSIONS: Deafness sometimes can be an early warning sign of impending vertebrobasilar ischemic stroke. Early recognition of deafness with acute ischemic stroke should allow special management, and misdiagnosis may result in significant morbidity, or even mortality.