くしゃみを契機に発症した椎骨動脈解離による小脳梗塞

抄録

　Abstract: We herein report the rare case of a patient who developed cerebellar infarction due to vertebral artery dissection, initially suspected as a perilymph fistula, immediately after a bout of sneezing. A 61-year-old man developed spontaneous vertigo and tinnitus immediately after a bout of sneezing. Initially there were no obvious findings on head CT, and he was referred to our department as a probable case of peripheral vestibular dysfunction. Since left hearing loss and rightward nystagmus were observed, we initially made the diagnosis of perilymph fistula. However, a repeat CT revealed cerebellar infarction of the region supplied by the posterior inferior cerebellar artery with vertebral artery dissection. This patient had complex mixed symptoms, including peripheral vestibular findings and central nervous system findings. We speculated that this patient might have had infarction of the posterior inferior cerebellar artery region, accompanied by decrease of the blood flow in the anterior inferior cerebellar artery, which caused hearing loss.