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Vertigo, stroke

Karolina Dorobisz, Tadeusz Dorobisz, Dariusz Janczak, Tomasz Krecicki
Stenosis of arteries that supplies blood to the brain is one of the main causes of ischemic stroke which is the third most common cause of deaths in Europe. Atherosclerosis of carotid and vertebral arteries is responsible for 20% of the ischemic stroke cases. Stenosis may be either asymptomatic or manifested with typical neurological symptoms including motor and sensory disturbances as well as disturbances in vision and speech. However, discrete non-specific symptoms of ischemia, including headaches and vertigo, tinnitus and hearing loss, are also quite common...
December 12, 2018: Acta Neurologica Belgica
Khushnuma A Mansukhani, Maria A Barretto, Sharmila A Donde, Jagruti Wandrekar, Advaita Nigudkar, Ridhi Nair
Background: There are few community-based neuroepidemiological studies based in tribal communities. This cross-sectional community-based study explored the prevalence rates of neurological disorders in the tribal region of Kaparada in Gujarat. Methodology: A two-stage methodology was used. Door-to-door surveys were conducted in the villages of Moti Vahiyal, Arnai, and Chavshala in Kaparada taluka in the Valsad district. Trained volunteers administered a questionnaire that assessed demographic details and common neurological symptoms in children and adults...
October 2018: Annals of Indian Academy of Neurology
Dao Pei Zhang, Hao Ran Li, Qian Kun Ma, Suo Yin, Yan Fang Peng, Huai Liang Zhang, Min Zhao, Shu Ling Zhang
Background and Purpose: The aim of this study was to determine the prevalence and associated factors of stroke and hypoperfusion among patients with isolated vertigo and vascular risk factors. Methods: We studied 157 patients with isolated vertigo who had undergone multimodal magnetic resonance imaging. Magnetic resonance angiography (MRA) was used to measure the diameters of vertebrobasilar arteries and to evaluate morphologic changes to vessels. Measurements obtained included length of the basilar artery and curvature index for the vertebral artery (VA)...
2018: Frontiers in Neurology
Bernardo Cacho-Díaz, Héctor Spínola-Maroño, Laura G Mendoza-Olivas
BACKGROUND AND PURPOSE: Cancer and stroke are the second and third causes of death worldwide; brain metastases (BM) occur in one third of patients with cancer, any neurologic deficit in these population always prompts the clinician to discard metastases for their presence carries a bad outcome. Both might share clinical presentation and differences in their outcome are not entirely known. The aim was to compare risk factors, clinical presentation, and outcome of cancer patients with BM vs stroke...
November 16, 2018: Current Problems in Cancer
Allison S Young, Sally M Rosengren, Miriam S Welgampola
Disorders of the inner-ear balance organs can be grouped by their manner of presentation into acute, episodic, or chronic vestibular syndromes. A sudden unilateral vestibular injury produces severe vertigo, nausea, and imbalance lasting days, known as the acute vestibular syndrome (AVS). A bedside head impulse and oculomotor examination helps separate vestibular neuritis, the more common and innocuous cause of AVS, from stroke. Benign positional vertigo, a common cause of episodic positional vertigo, occurs when otoconia overlying the otolith membrane falls into the semicircular canals, producing brief spells of spinning vertigo triggered by head movement...
2018: Handbook of Clinical Neurology
Fuyuki Tateno, Ryuji Sakakibara
We report 3 cases (69-year-old man, 71-year-old man, and 82-year-old woman) of isolated cerebellar nodulus stroke patients, who presented with positional vertigo alone that lasted only for 2-4 days. Brain magnetic resonance imaging helped diagnosing these cases. Although rare, clinicians should be aware of isolated cerebellar nodulus stroke, when facing with patients with paroxysmal vertigo of acute onset.
November 10, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
M V Zamergrad, S P Grachev, A A Gergova
Acute vestibular disorder is a frequent cause of urgent hospitalization in elderly patients. A CNS vascular disorder is often thought to be a cause of vertigo and a patient is diagnosed with stroke or transitory ischemic attack (TIA) or vertebral-basilar insufficiency. Despite the higher risk of cerebrovascular disease in the elderly, stroke and TIA are not the only cause of acute vestibular disorder. Hyperdiagnosis of cerebrovascular diseases in patients with acute vertigo often leads to underdiagnosis of peripheral vestibular disorders that could be successfully treated if timely diagnosed...
2018: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
Jae-Hwan Choi, Eun Hye Oh, Min-Gyu Park, Seung Kug Baik, Han-Jin Cho, Seo Young Choi, Tae-Hong Lee, Ji Soo Kim, Kwang-Dong Choi
The aim of this study was to determine the frequency, clinical and radiological features, and efficacy of clinical evaluation and perfusion-weighted imaging (PWI) for the prediction of final stroke in patients with DWI/MRI-negative posterior circulation stroke (PCS) presenting acute dizziness/vertigo. From our comprehensive prospective stroke registry of acute ischemic stroke during a 7-year period, we identified 1846 consecutive patients with PCS, 850 of whom presented with acute dizziness/vertigo. Of these 850 patients, initial DWI-MRI was negative in 35 (4...
December 2018: Journal of Neurology
Alisha Greer, Mark Hewitt
A short-cut review was carried out to establish whether a normal gait examination can rule out cerebellar stroke in patients with acute vertigo. 16 studies were relevant to the question. The author, year and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. The clinical bottom line is that a normal gait examination cannot rule out a cerebellar stroke but the presence of an abnormal gait can be associated.
November 2018: Emergency Medicine Journal: EMJ
Seonghwan Byun, Ji Ye Lee, Bo Gyung Kim, Hyun Sook Hong
RATIONALE: Acute unilateral audiovestibulopathy is a common neurotological syndrome. Differential diagnoses of acute unilateral audiovestibulopathy include viral infection, vascular insults, and tumors. Regarding vascular causes, ischemic stroke in the anterior inferior cerebellar artery (AICA) territory is known to be the leading cause of acute audiovestibular loss. Previous reports of AICA infarction with audiovestibulopathy failed to demonstrate magnetic resonance imaging (MRI)-positive vestibulocochlear infarctions...
October 2018: Medicine (Baltimore)
Pierre-Yves Courand, Michael Serraille, Adrien Grandjean, Caroline Tilikete, Hugues Milon, Brahim Harbaoui, Pierre Lantelme
OBJECTIVE: Dizziness is associated with hypertension but there are numerous other causes. The aims of the present study were to describe the characteristics and the clinical correlates of dizziness in a large cohort of hypertensive patients, and to test its prognostic value for all-cause, cardiovascular, and stroke mortality. METHODS: A total of 1716 individuals from the OLD-HTA Lyon's cohort of hypertensive patients recruited in the 1970s were categorized according to the absence or the presence of dizziness...
October 10, 2018: Journal of Hypertension
Matías J Alet, Virginia Pujol Lereis, Sebastián F Ameriso, Luis Lemme-Plaghos
We present two cases of lateral medullary stroke in subjects with extracranial trajectory of the postero-inferior cerebellar artery. Case 1: a 21-year-old male who presented ataxia and right dysmetria after cervical trauma in a rugby match. Case 2: 56-year-old woman, who started with vertigo and left hemiparesis after intense physical effort. In both cases, the angiographic studies showed an extracranial trajectory of the posterior inferior cerebellar artery. This vessel rarely originates below the foramen magnum, in close relationship with the first three cervical vertebrae and the atlanto-axial joint...
2018: Medicina
Kwang-Dong Choi, Ji-Soo Kim
Discriminating strokes in patients with acute dizziness/vertigo is challenging especially when other symptoms and signs of central nervous involvements are not evident. Despite the developments in imaging technology over the decades, a significant proportion of acute strokes may escape detection on imaging especially during the acute phase or when the lesions are small. Thus, small strokes causing isolated dizziness/vertigo would have a higher chance of misdiagnosis in the emergency department. Even though several diagnostic algorithms have been advanced for acute vascular vertigo, we still await more comprehensive and sophisticated ones that can also be applied to transient vestibular symptoms due to vascular compromise...
September 5, 2018: Journal of Neurology
Alper Yazıcı, Yusuf İnanç
Objectives: The aim of this study was to investigate the association between benign paroxysmal positional vertigo (BPPV) and vertebral artery (VA) flow rates and diameters by using Doppler ultrasonography in patients with BPPV. Additionally, we aimed to investigate the abnormalities of VA values obtained by extracranial color-coded duplex sonography in BPPV, which could be accepted as a precursor lesion for posterior cerebral ischemic stroke. Materials and methods: Between September 2017 to February 2018, 50 patients diagnosed with BPPV were enrolled in this study...
2018: Neuropsychiatric Disease and Treatment
Abhay Venkat, Cecilia Cappelen-Smith, Shabeel Askar, Peter R Thomas, Sonu Bhaskar, Amanda Tam, Alan J McDougall, Suzanne J Hodgkinson, Dennis J Cordato
BACKGROUND: Failure to recognise acute stroke may result in worse outcomes due to missed opportunity for acute stroke therapies. Our study examines factors associated with stroke misdiagnosis in patients admitted to a large comprehensive stroke centre. METHODS: Retrospective review comparing 156 consecutive stroke patients misdiagnosed in emergency department (ED) with 156 randomly selected stroke controls matched for age, gender, language spoken and stroke subtype for the period 2014-2016...
2018: Neuroepidemiology
Christopher Elnan Kvistad, Vojtech Novotny, Halvor Næss, Guri Hagberg, Hege Ihle-Hansen, Ulrike Waje-Andreassen, Lars Thomassen, Nicola Logallo
Background Stroke mimics are frequently treated with thrombolysis in clinical practice and thrombolytic trials. Although alteplase in stroke mimics has proven to be safe, safety of tenecteplase in stroke mimics has not been assessed in an ischemic stroke study setting. We aimed to assess clinical characteristics and safety of stroke mimics treated with thrombolysis in the Norwegian Tenecteplase Stroke Trial. We also aimed to identify possible predictors of stroke mimics as compared to patients with acute cerebral ischemia...
January 1, 2018: International Journal of Stroke: Official Journal of the International Stroke Society
Koji Hirashita, Atsushi Matsumoto, Satoru Yabuno, Takahiro Kanda, Masatoshi Yunoki, Kimihiro Yoshino
In Japan, hepatic arterial infusion chemotherapy (HAIC) using reservoir system is recommended for patients with hepatocellular carcinoma (HCC) whose hepatic spare ability is favorable. Arterial infusion catheter is commonly detained in hepatic artery via femoral or brachial artery. In our hospital, catheter is often inserted by puncturing the left subclavian or brachial artery considering the patient's activities of daily living (ADL) during long-term detaining. However, it rarely causes posterior circulation ischemic stroke because of the left vertebral artery branches on the path of catheter...
September 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Sung Eun Chung, Tae Hwan Yoon, Kyung Mi Lee, Hyug-Gi Kim, Bum Joon Kim
BACKGROUND: Cervical artery dissection is one of the most important causes of ischemic stroke in young age patients. However, multiple cervical artery dissection simultaneously involving the anterior and posterior circulation is uncommon. Here, we would like to report a case of a patient with bilateral vertebral artery (VA) and internal carotid artery dissection (ICA) after a use of systemic steroid due to peripheral facial palsy. CASE PRESENTATION: A 44-year-old man with hypertension visited emergency department due to recurrent vertigo...
May 28, 2018: BMC Neurology
Jennifer C Alyono
Vertigo and dizziness are common conditions among older adults. They are closely associated with fall risk and portend major implications for geriatric injury and disability. Management can be particularly challenging, because symptoms are often nonspecific and may reflect multiple etiologies. Chronic dizziness can reflect dysfunction in the vestibular, somatosensory, or visual systems or in their central integration. Systemic processes, such as postural hypotension, arrhythmias, heart failure, medication use, and lower extremity weakness or frailty, also contribute...
August 2018: Otolaryngologic Clinics of North America
Giampiero Neri, Vincenzo Marcelli, Luigi Califano
It is a well-known fact that inner ear diseases are often caused by microcirculatory disorders, and the recent literature is oriented towards investigations into the relationship between the cardiovascular system and cochleovestibular illness with related classical symptoms: tinnitus, hearing loss, and vertigo or instability. These symptoms, and particularly the vertigo, may be the alarm signal of microcirculatory disorders of the labyrinth or vertebrobasilar circulation so as to represent a possible symptom of posterior circulation stroke...
January 2018: International Journal of Immunopathology and Pharmacology
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