Objective: To describe cerebellar arteriovenous malformation in a 21-year-old man with symptoms resembling those of ear disease and to discuss the relationship between the findings of neurotologic examination and magnetic resonance imaging.
Study Design: Case report.
Setting: Department of Otolaryngology, Head-and-Neck Surgery of the Kyoto University Hospital, which is a tertiary care center, in Kyoto, Japan.
Patient: A 21-year-old man had cerebellar arteriovenous malformation and symptoms resembling those of ear disease: recurrent left facial paralysis, left retrocochlear hearing loss, and tinnitus. Auditory brainstem responses showed only waves I and II on his left side. Downbeat nystagmus was seen by anteflexion and retroflexion of his neck. He also experienced a slight sensory disturbance on the left side of his face and right lower extremity. Magnetic resonance imaging and vertebral angiography revealed a cerebellar arteriovenous malformation and a varix functioning as a drainer of the arteriovenous malformation surrounded by an edematous region probably induced by a small hemorrhage in the brainstem.
Intervention: Conservative treatment, including intravenous prednisolone, vitamin B-12 and oral adenosine triphosphate was performed followed by total extirpation of the arteriovenous malformation.
Conclusion: In examining patients with peripheral facial paralysis (sometimes recurrent with a short interval) and other symptoms resembling those of ear disease, especially those suggesting certain central disorders, it is important to take intracranial arteriovenous malformation into consideration because the condition may be sometimes life threatening if overlooked.