Sudden hearing loss as a primary symptom of stroke

Q: What is the clinical evidence from this study?

Study design: Case Report. Population: Basilar artery occlusion presenting with sudden bilateral hearing loss (n=1). Intervention: Acute mechanical thrombectomy. Primary outcome: Resolution of bilateral hearing loss and basilar artery recanalization.

Q: What does this research mean for the field?

Acute mechanical thrombectomy can achieve basilar artery recanalization and resolution of sudden bilateral hearing loss presenting as an initial symptom of posterior circulation stroke. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Tural Alamdari; Ronni Mikkelsen; Marie Louise Schmitz

doi:10.61409/v04260340

November 9, 2026Ugeskrift for LægerOpen Access

Sudden hearing loss as a primary symptom of stroke

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Key result

Mechanical thrombectomy achieves complete basilar artery recanalization and resolves sudden hearing loss within 48 hours.

n=1

Why the study?

Sudden bilateral hearing loss may have a vascular aetiology, particularly in patients with vascular risk factors, and can be an initial presenting symptom of a posterior circulation stroke.

Key Points

To describe sudden bilateral hearing loss as a rare initial presenting symptom of acute posterior circulation stroke.
Clinical evaluation of an 83-year-old woman presenting with acute bilateral hearing loss, vertigo, and nausea following a two-day pause in dabigatran therapy.
Diagnostic workup included cerebral CT, CT angiography, catheter-based angiography, and echocardiography.
Intervention consisted of emergency mechanical thrombectomy targeting a basilar artery occlusion.
Angiography revealed a thrombus in the middle basilar artery causing bilateral occlusion of the anterior inferior cerebellar arteries, which supply the internal auditory arteries.
Mechanical thrombectomy achieved complete recanalization of the basilar artery, and the bilateral hearing loss remitted approximately 48 hours after the procedure.
Echocardiography identified a left atrial appendage thrombus as the probable embolic source in the setting of atrial fibrillation and anticoagulation cessation.

Study Design

Type

Case Report (n=1)

Multicenter

No

Structured PICO

P

Population

1 83-year-old woman with atrial fibrillation and recent 2-day dabigatran cessation presenting with acute total bilateral hearing loss due to basilar artery occlusion.

I

Intervention

Acute mechanical thrombectomy of the basilar artery, followed by low-molecular-weight heparin 15,000 IU daily and subsequent popliteal artery embolectomy

O

Outcome

Complete recanalization of the basilar artery (with a small residual thrombus in parts of the right AICA) and remission of bilateral hearing loss at approximately 48 hours post-thrombectomyhard clinical

This case report highlights that sudden bilateral hearing loss can be the primary presenting symptom of a posterior circulation stroke (basilar artery occlusion) following short-term cessation of dabigatran in a patient with atrial fibrillation, and that timely mechanical thrombectomy can restore hearing.

Limitations

Single patient case report
Audio-vestibular symptoms are not captured by the standard National Institute of Health Stroke Scale (NIHSS)

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Implication

May prompt vascular imaging for sudden bilateral hearing loss in high-risk patients; leaves open whether thrombectomy routinely reverses auditory deficits in basilar occlusion.

Abstract

Sudden bilateral hearing loss may have a vascular aetiology, especially in patients with vascular risk factors. A woman in her early 80s presented with total bilateral hearing loss, vertigo, and nausea, while on short-term dabigatran cessation. The cause was determined to be a thrombus in the basilar artery, at the level where both anterior inferior cerebellar arteries originate. A successful thrombectomy was performed. In this case report, we wish to elucidate the possibility of bilateral hearing loss being an initial presenting symptom of a stroke affecting the posterior circulation.

Discussion

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Cite This Study

Alamdari et al. (2026) conducted a case report in Basilar artery occlusion presenting with sudden bilateral hearing loss (n=1). Acute mechanical thrombectomy was evaluated on Resolution of bilateral hearing loss and basilar artery recanalization. Acute mechanical thrombectomy achieved complete basilar artery recanalization and remission of sudden bilateral hearing loss within 48 hours in an 83-year-old woman with stroke.

synapsesocial.com/papers/6af46da27bb3da179b850210 https://doi.org/10.61409/v04260340

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Sudden hearing loss as a primary symptom of stroke

Key Points

Study Design

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Sudden hearing loss as a primary symptom of stroke

Key Points

Study Design

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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