Abstract
Isolated sensory hearing loss is usually associated with inner ear disorders we report two patients with clinical features of brain infarction in the distribution of the anterior inferior cerebellar artery (AICA), who had unilateral sensory hearing loss as an isolated symptom for several days or months prior to stepwise development of typical AICA infarction syndrome. Patient 1 was a 65-year-old hypertensive woman who was hospitalized at 10 days after the onset, because of vertigo, dysarthria, left hemiataxia and truncal ataxia, she initially developed left hearing loss at 20 days prior to admission. At 1 day after admission, she further developed left peripheral facial palsy, patient 2 was a 69-year-old hypertensive man with diabetes mellitus and hyperlipidemia. He suffered from right hearing loss at is months prior to admission, and then had sudden onset of vomiting and truncal ataxia. At 1 day after admission, he developed right facial numbness, right hemiataxia and left peripheral facial palay. In both patients, the final neurological features were compatible with AICA infarction syndrome. MRI demonstrated hyper-intense lesions in the lateral pons and middle cerebellar peduncle on T2-weighted images. Cerebral angiography confirmed a unilateral occulusion of the AICA in both patients. A combination of peripheral and central symptoms and signs, including VII and VIII nerve involvements, is characteristic of AICA infarction syndrome. Isolated sensory hearing loss may precede the full AICA infarction syndrome, depending on the anatomical variation of the branches of the AICA.
