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J Stroke. 2017 Jan;19(1):61-66. doi: 10.5853/jos.2016.00857. Epub 2016 Dec 12.

Recent Advances in Understanding Audiovestibular Loss of a Vascular Cause.

Kim HA1,2, Lee H1,2.

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1
Department of Neurology, Keimyung University School of Medicine, Daegu, Korea.
2
Brain Research Institute, Keimyung University School of Medicine, Daegu, Korea.

Abstract

Acute audiovestibular loss is characterized by abrupt onset of prolonged (lasting days) vertigo and hearing loss. Acute ischemic stroke in the distribution of the anterior inferior cerebellar artery (AICA) is known to be the leading cause of acute audiovestibular loss. So far, eight subgroups of AICA territory infarction have been identified according to the patterns of audiovestibular dysfunctions, among which the most common pattern is the combined loss of auditory and vestibular functions. Unlike inner ear dysfunction of a viral cause, which can commonly present as an isolated vestibular (i.e., vestibular neuritis) or cochlear loss (i.e., sudden deafness), labyrinthine dysfunction of a vascular cause rarely results in isolated loss of vestibular or auditory function. As audiovestibular loss may precede the central symptoms or signs of an ischemic stroke in the posterior circulation, early diagnosis and proper management of audiovestiubular loss may provide a window to prevent the progression of infarction to larger areas of the posterior circulation. A clinician should consider the possibility that acute audiovestibular loss may herald impending AICA territory infarction, especially when patients have basilar artery occlusive disease close to the origin of the AICA on brain MRA. This review aims to highlight the recent advances in understanding audiovestibular loss of a vascular cause and to address its clinical significance.

KEYWORDS:

Anterior inferior cerebellar artery; Audiovestibular loss; Hearing loss; Prodrome; Stroke; Vertigo

Conflict of interest statement

The authors have no financial conflicts of interest. Dr. Lee serves on the editorial boards of the Research in Vestibular Science, Frontiers in Neuro-otology, and Current Medical Imaging Review.

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