Abstract

Background
Acute ischemic stroke in the distribution of the anterior inferior cerebellar artery (AICA) is known to be associated with vertigo, hearing loss, nystagmus, facial weakness, and gait ataxia. Blood supply to the inner ear arises from the internal auditory artery, ordinarily a branch of the AICA, therefore a partial ischemia in the AICA distribution may manifest with an isolated inner ear infarction. Objectives: To describe the clinical features of 3 patients with an isolated inner ear infarction as a prodromal symptom of the AICA infarction.
Methods
Twenty-one consecutive cases of the AICA infarction diagnosed by brain MRI completed a standardized audiovestibular questionnaire and underwent a neurotological evaluation by a single neurotologist.
Results
Three patients had an isolated episode of prolonged deafness with vertigo as a prodrome of the AICA infarction 1-10 days prior to onset of other brainstem and/or cerebellar symptoms. All patients had a focal stenosis near the origin of the AICA. Extensive neurotologic evaluation suggested that an isolated deafness with vertigo before permanent AICA infarction is usually due to dysfunction of the cochlea, resulting from ischemia to the inner ear.
Conclusions
An isolated inner ear infarction may be a warning sign of an impending pontocerebellar infarction in the distribution of the AICA.