Sensorineural Hearing Loss Due to Vertebrobasilar Artery Ischemia–Illustrative Case and Literature Review

The majority of patients with acute sensorineural hearing loss have peripheral vestibulocochlear disorders such as sudden deafness or Meniere’s disease. However, ischemia of the vertebrobasilar artery can also cause vestibulocochlear symptoms such as sensorineural hearing loss and vertigo [1]. The vertebrobasilar artery supplies the inner ear, brainstem, and cerebellum. Ischemia of the vertebrobasilar artery may lead to infarctions of cerebellar arteries such as anterior inferior cerebellar artery (AICA), posterior inferior cerebellar artery (PICA) syndrome, superior cerebellar artery (SCA), or brain stem infarction. Further, the distributions and origins of the vertebrobasilar artery are various and complex. Symptoms depend on whether neural tracts are included within the ischemic lesion in the brain. Typically, a central lesion results in cerebellar symptoms or cranial nerve deficits as well as vestibulocochlear nerve and sensorimotor symptoms. Unless neuronal deficits other than sensorineural hearing loss and vertigo are present, hearing loss due to ischemia of the vertebrobasilar artery is very similar to peripheral vestibulocochlear disorders such as sudden deafness or Meniere’s disease [1]. Acute sensorineural hearing loss occurs at an estimated incidence of approximately 5 to 20 per 100,000 persons per year [2, 3]. The incidence of vertebrobasilar artery infarction in which patients initially present with acute sensorineural hearing loss is 1.2–1.4%, and 1.0–1.2% of these patients show only vestibulocochlear symptoms without other neurologic deficits [4,5].