Basilar artery occlusion presenting as sudden bilateral deafness: a case report

Area of Science:

• Neurology
• Vascular Neurology
• Otolaryngology

Background:

• Sudden hearing loss is typically otolaryngologic, rarely cerebrovascular.
• Bilateral sensorineural hearing loss can be a sign of vertebrobasilar artery occlusion.
• Early diagnosis is critical due to the poor prognosis of vertebrobasilar stroke.

Observation:

• A 73-year-old woman presented with sudden bilateral deafness, vertigo, and vomiting.
• Initial CT was unremarkable, but subsequent MRI revealed brainstem and cerebellar infarction.
• MR angiography demonstrated basilar artery occlusion due to a cardioembolic thrombus.

Findings:

• The patient experienced progressive neurological decline despite endovascular treatment.
• Post-mortem CT showed new brainstem lesions, cerebellar swelling, and hydrocephalus.
• Vertebrobasilar occlusive disease has a very poor prognosis.

Implications:

• Magnetic resonance imaging (MRI) and MR angiography (MRA) are vital for diagnosing vertebrobasilar artery occlusion.
• Suspect vertebrobasilar stroke in patients with bilateral sensorineural hearing loss and stroke risk factors.
• Prompt diagnosis and intervention are essential for potentially improving outcomes in vertebrobasilar stroke.