耳鼻咽喉科臨床
Online ISSN : 1884-4545
Print ISSN : 0032-6313
突然の難聴とめまいを主訴とした小脳梗塞3例
山口 宗一末野 康平山口 威田中 真琴柴 和孝浅野 友規美
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98 巻 (2005) 2 号 p. 99-103

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Sudden hearing loss or Meniere's disease are frequent diagnoses in case of sudden hearing loss and vertigo, but these symptoms may rarely be caused by cerebrovascular disorder. We recently encountered three patients with cerebellar infarction who demonstrated sudden hearing loss and vertigo as the chief complaints. Two of the patients demonstrated regression following treatment, but one patient suddenly deteriorated and died. We identified an infarct of the anterior inferior cerebellar artery area in all cases, but the general clinical manifestations varied slightly, making it is easy to be made a wrong diagnosis. MRI examination can even depict an early infarct. Therefore it is recommended MRI be obtained early in sudden hearing loss patients with vertigo. Quality of life and cerebellar function may remain almost good if not accompanied by disturbance of consciousness even if cerebellar infarction is not detcted early. However, some cases demonstrated a combination of wide cerebellar infarction and brain stem infarction, presenting grave clinical manifestations, and subsequent fatality. In addition, inquiry into anamnesis is important when cerebrovascular disorder is suspected. In the patient with a history of hypertension, diabetes mellitus, hyperlipemia, arterial sclerosis and heart failure, cerebellar infarction was taken into consideration and we monitored the course carefully. It was also thought that obtaining cranial MRI in the early stage was necessary.

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