Missed Anterior Inferior Cerebellar Artery Aneurysm Mimicking Vestibular Neuritis—Clues to Prevent Misdiagnosis

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• 作者：Jan-Folkard Willms ; MD^* ; Gerasimos Baltsavias ; MD^&dagger ; ; Jan-Karl Burkhardt ; MD^* ; Silvia Ernst ; MD^&Dagger ; ; Alexander A. Tarnutzer ; MD^* ; ^{alexander.tarnutzer@usz.ch}
• 关键词：MRI ; acute vestibular syndrome ; aneurysm ; anterior inferior cerebellar artery ; diagnostic errors
• 刊名：Journal of Stroke and Cerebrovascular Diseases
• 出版年：2016
• 出版时间：December 2016
• 年：2016
• 卷：25
• 期：12
• 页码：e231-e232
• 全文大小：261 K
• 卷排序：25

文摘

We discuss a case with combined vestibulocochlear and facial neuropathy mimicking a less urgent peripheral vestibular pattern of acute vestibular syndrome (AVS). With initial magnetic resonance imaging read as normal, the patient was treated for vestibular neuropathy until headaches worsened and a diagnosis of subarachnoid hemorrhage was made. On conventional angiography, a ruptured distal right-sided aneurysm of the anterior inferior cerebellar artery was diagnosed and coiled. Whereas acute vestibular loss usually points to a benign peripheral cause of AVS, combined neuropathy of the vestibulocochlear and the facial nerve requires immediate neuroimaging focusing on the cerebellopontine angle. Imaging should be assessed jointly by neuroradiologists and the clinicians in charge to take the clinical context into account.