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Images in Neurology |

Isolated Bilateral Anterior Inferior Cerebellar Artery Infarction

Dimitri Renard, MD; Guillaume Taieb, MD; Giovanni Castelnovo, MD; Salem Ghanem, MD; Xavier Ayrignac, MD; Pierre Labauge, MD, PhD
Arch Neurol. 2010;67(6):766-767. doi:10.1001/archneurol.2010.114.
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A 54-year-old man with arterial hypertension, hypercholesteremia, and tobacco use as cardiovascular risk factors presented with acute bilateral hearing loss, vertigo, dysarthria, and gait unsteadiness. Clinical examination showed left-sided limb ataxia, gaze-evoked nystagmus, dysarthria, and profound bilateral sensorineural hearing loss. Pure-tone audiogram revealed loss of 80 dB and more than 90 dB on the right and left sides, respectively. Auditory brainstem responses were normal. Brain magnetic resonance imaging showed acute bilateral anterior inferior cerebellar artery (AICA) infarction (Figure). Magnetic resonance imaging and computed tomographic angiography revealed multifocal vertebrobasilar stenosis in absence of anatomical variants (eg, dominant AICA). Spontaneous complete recovery of hearing loss and other brainstem signs was seen progressively for days.

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Figure.

Fluid-attenuated inversion recovery (A-C) and diffusion-weighted imaging (D-F) sequences show bilateral hyperintense signal in the middle cerebellar peduncles (arrowheads) and the anterior inferior cerebellum (arrows) consistent with isolated bilateral acute infarction in the distribution of the anterior inferior cerebellar artery.

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