Clinical Analysis Of Cerebrovascular Diseases Mainly Presented With Auditory Dysfunction And Literature Review

Objective : The paper describes the morbidity,etiology,pathogenesis,diagnosis,treatment strategy and prognosis of CVD with auditory dysfunction as the main manifestation in order to deepen the cognition and understanding on patients with CVD accompanied by auditory dysfunction for clinicians.It should be as soon as possible to make the correct diagnosis and intervene actively to prevent the disease progression or life-threatening.Methods : The history,clinical manifestations,laboratory,auditory vestibular function and imaging examination,treatment and prognosis of three patients with CVD accompanied by auditory dysfunction were analyzed retrospectively.The three patients underwent magnetic resonance imaging(MRI)and magnetic resonance angiography(MRA),pure tone audiogram(PTA),carotid ultrasound,transcranial Doppler(TCD)and other examinations.Two patients completed eye electroretinogram examination and brainstem auditory evoked potentials(BAEP),two patient completed internal auditory canal MRI and two underwent bithermal caloric test.And the two patients were examined by an ENT doctor.The clinical characteristics were summarized based on the clinical data and literature review.Results : Three patients showed auditory dysfunction,and two patients showed auditory dysfunction with dizziness.Brain CT showed bilateral radiolabel,lateral ventricle periventricular leucopenia demyelinating lesions,it is recommended that further MRI in addition to acute cerebral infarction;bilateral internal carotid artery intracranial atherosclerosis.Brain MRI showed bilateral frontal temporal lobe multiple small ischemic foci and MRA no abnormalities,vertebrobasilar artery no stenosis or occlusion in one patient.PTA showed right ear hearing test prompted moderate sensorineural hearing loss;left ear hearing test prompted mild sensorineural hearing loss.Eye electroretinogram examination showed no obvious abnormalities in the eye movement system;static position test(+)in the first time and showing spontaneous nystagmus(+)in the second time.The bithermal caloric test is normal.BAEP showed stimulation of left and right ears induced auditory evoked potential showed poor reproducibility of bilateral waves,suggesting that bilateral brainstem auditory conduction function is poor,especial the left side.Internal auditory canal MRI showed the close relationship between bilateral anterior inferior cerebella artery and bilateral auditory nerve.We used aspirin anti-platelet aggregation,state stable plaque,improve the circulation and other treatment,the patient's clinical symptoms were relieved,the treatment is effective.Brain MRA showed bilateral vertebrae-basilar artery curvilinear,brain stem mildly under pressure and internal auditory canal MRI showed the close relationship between bilateral anterior inferior cerebella artery and bilateral auditory nerve in the other patient.PTA showed bilateral profound sensorineural hearing loss.We used the foreground to improve the cycle,antispasmodic,olivacavir nutrition and protection of the brain and stating therapy.The patient described cranial symptoms and the auditory function of the left side improved.Brain MRI showed no significant abnormalities and MRA showed bilateral embryonic posterior cerebral artery in the third patient.Cervical arterial magnetic resonance imaging showed right vertebral artery intracranial segment small.There is no obvious abnormality in the eye movement of the video eye diagram;dynamic position test(-).The bithermal caloric test is normal.We used the drugs to relieve dizziness and improve circulation and statin treatment.Finally the patient was not complaining of dizziness,vomiting as well as tinnitus,hearing loss.Conclusion:The incidence of CVD mainly presented with auditory dysfunction is relatively low.At present,we have already had some common conclusion of its pathology,etiology and clinical manifestation.Patients with auditory dysfunction should undergo cerebrovascular examinations as soon as possible.Treatments for CVD with auditory dysfunction are drug,surgery and endovascular methods.And ultimately according to the specificity of patients and the specificity of vascular structure to choose the most safe and effective treatment.Clinical characteristics including dizziness or vertigo,multiple risk factors for atherosclerosis,and basilar artery stenosis or curvature indicate a high risk of CVD.