Isolated labyrinthine infarction as a harbinger of anterior inferior cerebellar artery territory infarction with normal diffusion-weighted brain MRI

Ji Soo Kim, Kyung-Hee Cho, Hyung Lee

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41 Citations (Scopus)

Abstract

Objectives: This paper aims to determine the frequency of isolated labyrinthine infarction as an initial manifestation of anterior inferior cerebellar artery (AICA) territory infarction and discuss its clinical implication. Methods: We studied 54 consecutive patients with AICA infarction diagnosed by brain MRI from the acute stroke registry. Results: We identified 4 patients (7.4%) with AICA territory infarction who initially presented with vertigo and hearing loss mimicking acute labyrinthitis and subsequently suffered from delayed neurological deficits. All patients had normal brain MRIs including diffusion-weighted images at the time of isolated audiovestibular loss, but all subsequently exhibited acute infarct(s) in the AICA territory on follow-up brain MRIs when they developed additional neurological deficits. Conclusion: Labyrinthine infarction may be a warning sign of impending pontocerebellar infarction in the AICA territory. Our results indicate that even a classical peripheral presentation, e.g., acute hearing loss, and acute vertigo with unidirectional nystagmus, may be a manifestation of ischemic stroke in the posterior circulation.

Original languageEnglish
Pages (from-to)82-84
Number of pages3
JournalJournal of the Neurological Sciences
Volume278
Issue number1-2
DOIs
Publication statusPublished - 2009 Mar 15
Externally publishedYes

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Diffusion Magnetic Resonance Imaging
Infarction
Arteries
Brain
Vertigo
Hearing Loss
Labyrinthitis
Stroke
Pathologic Nystagmus
Brain Infarction
Registries

Keywords

  • Anterior inferior cerebellar artery
  • Infarction
  • Inner ear
  • Prodrome

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

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abstract = "Objectives: This paper aims to determine the frequency of isolated labyrinthine infarction as an initial manifestation of anterior inferior cerebellar artery (AICA) territory infarction and discuss its clinical implication. Methods: We studied 54 consecutive patients with AICA infarction diagnosed by brain MRI from the acute stroke registry. Results: We identified 4 patients (7.4{\%}) with AICA territory infarction who initially presented with vertigo and hearing loss mimicking acute labyrinthitis and subsequently suffered from delayed neurological deficits. All patients had normal brain MRIs including diffusion-weighted images at the time of isolated audiovestibular loss, but all subsequently exhibited acute infarct(s) in the AICA territory on follow-up brain MRIs when they developed additional neurological deficits. Conclusion: Labyrinthine infarction may be a warning sign of impending pontocerebellar infarction in the AICA territory. Our results indicate that even a classical peripheral presentation, e.g., acute hearing loss, and acute vertigo with unidirectional nystagmus, may be a manifestation of ischemic stroke in the posterior circulation.",
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N2 - Objectives: This paper aims to determine the frequency of isolated labyrinthine infarction as an initial manifestation of anterior inferior cerebellar artery (AICA) territory infarction and discuss its clinical implication. Methods: We studied 54 consecutive patients with AICA infarction diagnosed by brain MRI from the acute stroke registry. Results: We identified 4 patients (7.4%) with AICA territory infarction who initially presented with vertigo and hearing loss mimicking acute labyrinthitis and subsequently suffered from delayed neurological deficits. All patients had normal brain MRIs including diffusion-weighted images at the time of isolated audiovestibular loss, but all subsequently exhibited acute infarct(s) in the AICA territory on follow-up brain MRIs when they developed additional neurological deficits. Conclusion: Labyrinthine infarction may be a warning sign of impending pontocerebellar infarction in the AICA territory. Our results indicate that even a classical peripheral presentation, e.g., acute hearing loss, and acute vertigo with unidirectional nystagmus, may be a manifestation of ischemic stroke in the posterior circulation.

AB - Objectives: This paper aims to determine the frequency of isolated labyrinthine infarction as an initial manifestation of anterior inferior cerebellar artery (AICA) territory infarction and discuss its clinical implication. Methods: We studied 54 consecutive patients with AICA infarction diagnosed by brain MRI from the acute stroke registry. Results: We identified 4 patients (7.4%) with AICA territory infarction who initially presented with vertigo and hearing loss mimicking acute labyrinthitis and subsequently suffered from delayed neurological deficits. All patients had normal brain MRIs including diffusion-weighted images at the time of isolated audiovestibular loss, but all subsequently exhibited acute infarct(s) in the AICA territory on follow-up brain MRIs when they developed additional neurological deficits. Conclusion: Labyrinthine infarction may be a warning sign of impending pontocerebellar infarction in the AICA territory. Our results indicate that even a classical peripheral presentation, e.g., acute hearing loss, and acute vertigo with unidirectional nystagmus, may be a manifestation of ischemic stroke in the posterior circulation.

KW - Anterior inferior cerebellar artery

KW - Infarction

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KW - Prodrome

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