PMC5610834_01
Magnetic Resonance Angiography (MRA) showing narrowing of the common carotid arteries bilaterally and the left subclavian artery (large arrowhead). Vertebral and intracranial carotid arteries were normal bilaterally.
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Magnetic Resonance Angiography (MRA) confirmed diagnosis (Figure 1).
Volume-rendered reconstructions from Magnetic Resonance Angiography examination showing diffuse narrowing of the left subclavian artery (a) and common carotid arteries bilaterally (b). Normal caliber was found for intracranial arteries ((c)-(d)).
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Volume-rendered reconstructions from MRA are shown in Figure 2.
PTA in our patient recorded one, three, and 14 days after onset of Sudden Sensorineural Hearing Loss in the right ear (first episode). (a) Pure Tone Audiometry recorded one day after hearing loss onset showing a moderate sensorineural hearing loss in the right ear with an average auditory threshold of 49.54 dB HL and normal hearing threshold in the left side. (b) Pure Tone Audiometry recorded three days after hearing loss onset; hearing in the right side significantly improved (average threshold: 23.2 dB HL). (c) When recording Pure Tone Audiometry 14 days after sudden hearing loss onset, and 4 days after cessation of high-dose corticosteroid therapy, hearing in the right ear returned to previous levels with an average threshold of 54.09 dB HL.
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PTA showed moderate sensorineural hearing loss in the right ear with an average PTA threshold of 49.54 dB HL and normal hearing in the left side (Figure 3(a)). HL) (Figure 3(b)) but deteriorated close to previous level (average threshold in the right ear: 54.09 dB HL) 14 days after cessation of therapy, as shown in Figure 3(c). Hearing remained stable over the following months.
Pure Tone Audiometry recorded one, 14, and 60 days after onset of sudden hearing loss in the left ear (second episode). (a) Pure Tone Audiometry confirmed hearing loss in the left ear, with an average threshold of 38.18 dB HL; threshold in the right ear was unmodified compared to the exam performed 14 days after cessation of previous treatment (56.09 dB HL); (b) Pure Tone Audiometry recorded 14 days after hearing loss onset showed a significant improvement of hearing loss in the left ear (average: 22.72 dB HL) but also in the right ear (average: 30.45 dB HL); (c) Audiometry 60 days after left sudden hearing loss onset showed no significant differences compared to previous exam, with preserved hearing threshold in both ears.
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PTA confirmed a new onset SSHL in the left ear, with an average PTA threshold of 38.18 dB HL; threshold in the right ear was unmodified compared to the exam performed 14 days after cessation of previous treatment (56.09 dB HL) (Figure 4(a)). HL in the left ear (average: 22.72 dB HL) but also in the right ear (average: 30.45 dB HL) (Figure 4(b)). Hearing thresholds in both ears remained stable over the following two months (Figure 4(c)).