Labyrinthine Infarction Documented on Magnetic Resonance Imaging

초록

A 78-year-old man with hypertension presented withacute vertigo and hearing loss in the right ear thathad started 1 day before. The vertigo prevented himfrom walking without assistance.The key neurotologic examination findings are sum-marized in the Table. Neurological examination showeda right hypotropia due to skew deviation (Figure 1A).A left-beating nystagmus was observed using Frenzelgoggles. Bedside head impulse tests (HITs) were posi-tive to the right. Finger rub tests detected right hear-ing loss. Urgent diffusion-weighted image showed nodiscernible findings. Video-oculography documentedspontaneous nystagmus beating leftward and down-ward. Video-HITs were positive for the horizontaland posterior canals bilaterally (Figure 1B). Bither-mal caloric tests showed a right canal paresis. Pure-tone audiometry documented hearing loss in the rightear (Figure 1C). With a suspicion of a false-negativediffusion-weighted image, the patient was treated with100 mg of aspirin and 40 mg of atorvastatin per day.Follow-up imaging 5 days later revealed a high-signal-intensity lesion confined to the right labyrinth on fluid-attenuated inversion recovery images (Figure 1D).Although the vertigo improved 1 week later, hearingloss remained unchanged during the follow-up of 3months

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