Sudden deafness associated with spontaneous dissection of vertebral artery

Abstract

Sudden deafness is a relatively common otologic emergency; it may be associated to a vertiginous syndrome. lt is mostly idiopathic. However, in some cases it's possible to identify the etiology. When a central neurological cause is responsible for this symptom, often coexist other deficits, but sometimes, these can pass unidentified.

We present the case of a 31 year old woman that went to our hospital because she had a sudden onset of vertigo with vomits during an air flight. Some hours after she noted the sudden appearance of hearing loss and tinnitus on the right ear. The otoneurologic examination showed right cophosis and nystagmus. The MRI showed an infarction of the postero-inferior cerebellar artery territory (PICA).

Later, angiography revealed right vertebral artery dissection. She was submitted to conservative treatment with partial recovery of the hearing and complete recovery of the other complaints. The deafness might be explained, by injury of the internal auditory artery that in some cases emerges from the PICA.