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양측 전하소뇌동맥 폐색으로 인한 급성 전정증후군 및 청각 증상

Acute Vestibular Syndrome with Auditory Symptoms due to Bilateral Anterior Inferior Cerebellar Artery Occlusion

Article information

J Korean Neurol Assoc. 2025;43(2):116-117
Publication date (electronic) : May 1, 2025
doi : http://dx.doi.org/10.17340/jkna.2024.0069
Yoon Seob Kim, MD, Jin Wook Choi, MD, PhDa, Seong-Joon Lee, MD, PhD
Department of Neurology, Ajou University Hospital, Suwon, Korea
aDepartment of Radiology, Ajou University Hospital, Suwon, Korea
김윤섭, 최진욱a, 이성준
아주대학교병원 신경과
a아주대학교병원 영상의학과
Address for correspondence Seong-Joon Lee, MD, PhD Department of Neurology, Ajou University Hospital, 164 World cup-ro, Yeongtong-gu, Suwon 16499, Korea Tel: +82-31-219-5175 Fax: +82-31-219-5178 E-mail: editisan@gmail.com
received : November 8, 2024 , rev-recd : February 4, 2025 , accepted : February 18, 2025 .

62세 남자가 심방세동 병력과 함께 양측 이명 및 난청을 동반한 갑작스러운 현기증, 구역, 구토로 방문하였다. 뇌 computed tomography (CT) 혈관 촬영에서 기저동맥 중간부에 양측 전하소뇌동맥을 폐색하는 색전이 확인되어 응급 혈관 내 시술로 제거한 후 증상이 호전되었다. 시술 전 자기공명확산강조영상에서는 소뇌 타래의 국소 뇌경색이 보였고 시술 후 진행된 비디오두부충동 검사 및 온도안진 검사에서 우측 가쪽 반고리관 감쇠 및 말초안진이 확인되었다. 전하소뇌동맥의 폐색은 미로동맥을 통해 소뇌타래, 결절뿐만 아니라 말초전정기관에도 혈류를 공급하기 때문에 중추와 말초 신경안과학적 소견을 모두 나타낼 수 있다[1]. 본 증례는 혈관 위험인자가 있는 환자의 급성 전정증후군에서 돌발 양측 청각장애가 나타날 경우 소뇌 또는 내이의 관류장애 가능성도 고려해야 함을 시사한다(Fig.) [2].

Figure.

(A) Digital subtraction angiography confirming the presence of thrombus at the suspected site (red arrow). (B) Follow-up angiography after thrombectomy of occluded portion, with reconstituted flow of both anterior inferior cerebellar arteries (orange arrow). (C) MR diffusion-weighted image before procedure, showing focal infarction at the flocculus of cerebellum (orange arrow). (D) Pure tone audiometry, indicating no significant hearing loss after procedure. (E) Alternate caloric test, showing 56.6% right unilateral weakness. (F) Video head impulse test shows decreased right lateral gain (0.66) with covert and overt saccades. MR, magnetic resonance.

Notes

ACKNOWLEDGEMENTS

This work was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (NRF-2021R1I1A1A01048331; S-JL).

References

1. Kim JS, Cho KH, Lee H. Isolated labyrinthine infarction as a harbinger of anterior inferior cerebellar artery territory infarction with normal diffusion-weighted brain MRI. J Neurol Sci 2009;278:82–84.
2. Huang MH, Huang CC, Ryu SJ, Chu NS. Sudden bilateral hearing impairment in vertebrobasilar occlusive disease. Stroke 1993;24:132–137.

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Copyright © 2025 by Korean Neurological Association

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Figure.

Figure.

(A) Digital subtraction angiography confirming the presence of thrombus at the suspected site (red arrow). (B) Follow-up angiography after thrombectomy of occluded portion, with reconstituted flow of both anterior inferior cerebellar arteries (orange arrow). (C) MR diffusion-weighted image before procedure, showing focal infarction at the flocculus of cerebellum (orange arrow). (D) Pure tone audiometry, indicating no significant hearing loss after procedure. (E) Alternate caloric test, showing 56.6% right unilateral weakness. (F) Video head impulse test shows decreased right lateral gain (0.66) with covert and overt saccades. MR, magnetic resonance.