Sudden onset hearing loss and vertigo just before posterior inferior cerebellar artery infarction (lateral medulla syndrome).

A 49-year-old woman presented with left-sided sudden hearing loss and tinnitus 1 (Day 1). Audiometric testing revealed a downsloping sensorineural hearing loss and 25% speech discrimination scores at 50 dBHL. She was diagnosed with left idiopathic sudden sensorineural hearing loss (SSNHL) and was managed with intravenous prednisolone administration (beginning at 60 mg/d). On Day 2, she experienced vertigo and, in the emergency department, was found to have a left-beating nystagmus with a torsional component and no other cerebellar