Sudden Bilateral Deafness

Basilar artery occlusion is associated with a high mortality rate and poor functional outcome in survivors. The most common prodromal symptoms are motor and oculomotor deficits. Hearing loss is not a major prodromal symptom. Sudden deafness usually results from either circulatory disturbances or inflammation. Deafness of vascular etiology generally occurs unilaterally. Occlusion of basilar arterial origin suggests that thrombosis is the primary mechanism of stroke, especially in elderly patients. This case highlights the importance of hearing loss as either a main manifestation or a warning of impending brainstem ischemia. Clinicians should be aware of the possibility of vertebrobasilar ischemia in patients with bilateral sudden deafness, even when classic brainstem or cerebellar signs are mild or absent. This case also highlights the importance of prodromal signs and symptoms.