Sudden deafness as a prodrome of cerebellar artery infarction: Three case reports

To summarize the clinical characteristics of acute cerebral infarction (ACI) in patients with sudden deafness (SD) as the first symptom, improve the awareness of the disease, and help diagnosis and treatment.

From 2019 to 2020, three patients with ACI with SD as the first symptom were admitted to our hospital. Pure tone audiometry, head magnetic resonance imaging (MRI), vertebral artery and carotid artery B-ultrasound, head and neck computed tomography angiography, and other examinations were performed. Following the treatment of SD, hearing and dizziness were not significantly improved. Then, the patients developed symptoms of related cranial nerve injury, and brain MRI showed cerebral infarction in the cerebellopontine angle area. All three cases were transferred to the neurology department for relevant conservative treatment.

Patients with ACI with SD as the first symptom usually attend the otolaryngology clinic. Here a diagnosis of SD, which is based on an audiological examination, is made and the corresponding treatment is administered. To reduce the misdiagnosis of this disease, close attention should be paid to the changes in the patient's clinical symptoms and related auxiliary examinations should be performed, such as brain MRI and cerebrovascular imaging. Otolaryngologists should pay attention to the type and severity of hearing loss, the accompanying symptoms, age, high-risk factors for cerebral infarction, and related cranial nerve symptoms in patients with SD. If the patient's early brain MRI does not show abnormalities, monitoring remains essential. The head MRI should be analyzed quickly based on the changes in the symptoms of the patient, to make an accurate diagnosis and provide the timely and correct treatment for the patients.