![]() Several factors such as inflammation, infection, trauma, aging (presbycusis), ototoxic drugs, autoimmune conditions, rupture of the labyrinthine membrane, and vascular insufficiency may be involved. The aetiology and pathogenesis of SSNHL are unclear but they may be multifactorial. The US National Institute for Deafness and Communication Disorders defines SSNHL as an idiopathic hearing loss of at least 30 dB over at least 3 test frequencies within 72 hours. Sudden sensorineural hearing loss (SSNHL) is a sudden and unexplained hearing loss that is frequently unilateral. It is necessary to consider the possibility of a central cause in patients with AHL and vertigo, and it is important to confirm this possibility through brain magnetic resonance imaging (MRI), including PWI, and magnetic resonance angiography (MRA). Our case highlights a case of AHL and vertigo presented by isolated cerebellar hypoperfusion without infarction. Additionally, perfusion computed tomography (CT) showed that perfusion deficits remained in the left cerebellum along the PICA and AICA territories. A follow-up PTA documented persistent unilateral SSNHL in the left ear. Two months later, the patient had no vertigo but still had hearing impairment in his left ear. ![]() Diffusion-weighted imaging (DWI) and perfusion-weighted imaging (PWI) showed territorial perfusion deficits in the left posterior inferior cerebellar artery (PICA) and anterior inferior cerebellar artery (AICA) without infarction. PTA showed mild unilateral SSNHL in the left ear. Additionally, he had apogeotropic nystagmus during head turns to either side. On neurological examination, he had vibration-induced right-beating nystagmus and left-beating nystagmus after a head-shaking test. Case presentationĪ 51-year-old man suddenly developed acute hearing loss (AHL) in his left ear and vertigo. We describe a patient who developed unilateral SSNHL and vertigo as initial symptoms caused by cerebellar hypoperfusion by vertebral artery (VA) dissection without the occurrence of infarction. However, cases in which SSNHL and vertigo occur with hypoperfusion alone are very rare. Acute audiovestibular loss is common with ischaemic stroke in the territory of the anterior inferior cerebellar artery (AICA). The definition of sudden sensorineural hearing loss (SSNHL) is broadly accepted as acute sensorineural hearing loss of more than 30 dB over at least three consecutive frequencies in a pure-tone audiogram (PTA).
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