脳梗塞による突発難聴の３症例

Abstract

Case 1: a 59-year-old male with a one-year history of diabetes mellitus complained of right sudden deafness with vertigo. Otoneurological examinations showed sensorineural hearing loss of the right ear and bidirectional horizontal gaze nystagmus. MRI revealed infarction of the right cerebellar hemisphere indicating occlusion of the anterior inferior cerebellar artery (AICA). With conservative treatment his hearing returned to the contralateral ear level. Case 2: a 49-year-old female who complained of right sudden deafness with vertigo and ipsilateral facial palsy. Audiometric studies showed total deafness on the right. Bidirectional horizontal gaze nystagmus, together with V, VII, IX and X cranial nerve palsies were recognized. CT and MRI proved infarction of the right cerebellum and pons. Her hearing improved only partially. Other neurological signs disappeared within eight months. Case 3: a 54-year-old male with a history of hypertension and angina pectoris complained of right sudden deafness with dizziness. Right sensorineural hearing loss and spontaneous nystagmus toward the left were noted. His hearing improved on the next day. Two days later, however, he lost consciousness. CT showed no abnormality, but angiography revealed occlusion of the basilar artery.These three cases showed the importance of differential diagnosis between acute hearing loss due to cerebral infarction and idiopathic sudden deafness. We emphasize the diagnostic importance of risk factors such as hypertension and diabetes mellitus and the sign of vertigo with nystagmus of central origin in cases of cerebral infarction.