A Case of Bilateral Hearing Loss

Area of Science:

• Neurology
• Vascular Neurology
• Neuroimaging

Background:

• Posterior circulation strokes can manifest with diverse neurological deficits.
• Vertigo, imbalance, and vomiting are common symptoms, but bilateral hearing loss is an atypical presentation.

Purpose of the Study:

• To report a unique case of posterior stroke.
• To highlight bilateral vertebral artery occlusion as a cause of stroke with unusual symptoms.

Main Methods:

• Case report of a 53-year-old male presenting with acute neurological symptoms.
• Diagnostic evaluation included Head Impulse- Nystagmus-Test of Skew (HINTS) exam, computed tomography angiography (CTA) of the head and neck, and magnetic resonance imaging (MRI).

Main Results:

• The patient experienced acute bilateral hearing loss, vertigo, and vomiting.
• HINTS exam suggested a central neurologic process.
• CTA revealed near-total bilateral vertebral artery occlusions.
• MRI demonstrated multiple infarcts in the cerebellum, medulla, and occipital lobes.

Conclusions:

• Bilateral vertebral artery occlusion is a rare cause of posterior stroke.
• Bilateral hearing loss can be a prominent, albeit uncommon, symptom of posterior circulation stroke.
• Prompt neuroimaging is crucial for diagnosing stroke and identifying underlying vascular pathologies.