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https://www.readbyqxmd.com/read/28314977/isolated-vestibular-syndromes-due-to-brainstem-and-cerebellar-lesions
#1
Sung-Hee Kim, Hyo Jung Kim, Ji-Soo Kim
Dizziness/vertigo is the most common symptoms of posterior circulation strokes. Isolated vestibular symptoms and signs without other neurologic deficits have been found in infarctions involving the brainstem and cerebellum. In the brainstem, infarctions responsible for isolated vestibular syndrome are usually restricted to the dorsal portion that contains the vestibular nucleus and the nucleus prepositus hypoglossi. Cerebellar lesions confined to the flocculus, tonsil, and nodulus also produce isolated vertigo and imbalance...
March 17, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28271170/acute-vestibular-syndrome-in%C3%A2-cerebellar-stroke-a%C3%A2-case-report-and-review-of-the-literature
#2
V Volgger, R Gürkov
The current paper reports on a patient with recurrent rotational vertigo and persistent dizziness and imbalance lasting several weeks, who underwent extensive neuro-otological and radiological examinations. Pathological findings initially included right-sided benign paroxysmal positional vertigo (BPPV), persistent horizontal spontaneous nystagmus (SPN) to the left, and a pathological bedside and video head impulse test (HIT) on the left. The pathological HIT on the left and the SPN to the left indicated a central origin...
March 7, 2017: HNO
https://www.readbyqxmd.com/read/28256416/the-triage-score-for-vertigo-or-dizziness-a-diagnostic-model-for-stroke-in-the-emergency-department
#3
R Kuroda, T Nakada, T Ojima, M Serizawa, N Imai, N Yagi, A Tasaki, M Aoki, T Oiwa, T Ogane, K Mochizuki, M Kobari, H Miyajima
BACKGROUND: Vertigo or dizziness is a common occurrence, but it remains a challenging symptom when encountered in the emergency department (ED). A diagnostic score for stroke with high accuracy is therefore required. METHODS: A single-center observational study (498 patients) was conducted. The predictor variables were derived from a multivariate logistic regression analysis with Akaike information criterion. The outcome was the occurrence of stroke. We evaluated the utility of a new diagnostic score (TriAGe+) and compared it with the ABCD2 score...
February 27, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28250326/medication-and-driving-appropriate-interventions
#4
Masahito Hitosugi
 Sudden illness while driving has been identified as a major cause of vehicle collisions, accounting for approximately 1 in 10 collisions. Because most drivers who experience sudden illnesses while driving do not perform avoidance maneuvers, the improvement of drivers' health is being promoted as a traffic safety strategy. Although stroke, heart disease, and epilepsy are common causes of sudden illness, common symptoms, such as abdominal cramps, vertigo, and syncope can also cause problems during driving...
2017: Yakugaku Zasshi: Journal of the Pharmaceutical Society of Japan
https://www.readbyqxmd.com/read/28238395/profound-hypotension-and-bradycardia-in-the-setting-of-synthetic-cannabinoid-intoxication-a-case-series
#5
David O Andonian, Shauna R Seaman, Elaine B Josephson
Cannabinoids are the most commonly used illegal substances in the world [1]. Synthetic Cannabinoids (SCB) are also known as "Spice", "K2", "Spike", "herbal incense", "Cloud 9", "Mojo" and many others are becoming a large public health concern due to their increasing use, unpredictable toxicity, and abuse potential [2]. The most common reported toxicities with SCB use based on studies using Texas Poison control record are tachycardia, agitation and irritability, drowsiness, hallucinations, delusions, hypertension, nausea, confusion, dizziness, vertigo, chest pain, acute kidney injury, seizures, heart attacks and both ischemic and hemorrhagic strokes [3]...
January 12, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28150010/-acute-vestibular-syndrome-following-cerebellar-stroke-case-report-and-literature-review-german-version
#6
V Volgger, R Gürkov
The current paper reports on a patient with recurrent rotational vertigo and persistent dizziness and imbalance lasting weeks, who underwent extensive neurootological and radiological examination. Pathological findings initially included right-sided benign paroxysmal positional vertigo (BPPV), persistent horizontal spontaneous nystagmus (SPN) to the left and a pathological bedside and video head impulse test (HIT) on the left. The pathological HIT on the left and SPN to the left indicated a central genesis...
February 1, 2017: HNO
https://www.readbyqxmd.com/read/28117210/cryptic-recanalization-of-chronic-vertebral-artery-occlusion-by-head-rotation
#7
Kenji Yagi, Hiroshi Nakagawa, Hideo Mure, Shinya Okita, Shinji Nagahiro
BACKGROUND: Chronic vertebral artery occlusion (VAO) can be associated with ischemic stroke, as thrombi formed under blood flow stagnation around the stump of the VAO may migrate into the brain. We report a new mechanism of chronic VAO-associated ischemic stroke and a patient with cryptic recanalization of chronic VAO by head rotation. CASE DESCRIPTION: A 74-year-old man presented with chronic right VAO and repeated ischemic embolic stroke in the posterior circulation despite antiplatelet therapy...
January 20, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28030893/recent-advances-in-understanding-audiovestibular-loss-of-a-vascular-cause
#8
REVIEW
Hyun-Ah Kim, Hyung Lee
Acute audiovestibular loss is characterized by abrupt onset of prolonged (lasting days) vertigo and hearing loss. Acute ischemic stroke in the distribution of the anterior inferior cerebellar artery (AICA) is known to be the leading cause of acute audiovestibular loss. So far, eight subgroups of AICA territory infarction have been identified according to the patterns of audiovestibular dysfunctions, among which the most common pattern is the combined loss of auditory and vestibular functions. Unlike inner ear dysfunction of a viral cause, which can commonly present as an isolated vestibular (i...
January 2017: Journal of Stroke
https://www.readbyqxmd.com/read/27890763/positional-occlusion-of-vertebral-artery-due-to-cervical-spondylosis-as-rare-cause-of-wake-up-stroke-report-of-two-cases
#9
Hirofumi Nishikawa, Fumitaka Miya, Yotaro Kitano, Genshin Mori, Shigetoshi Shimizu, Hidenori Suzuki
BACKGROUND: Positional compression of the vertebral artery (VA) owing to cervical spondylosis is an uncommon cause of stroke. We report two cases of cervical spondylosis causing wake-up stroke, which is extremely rare. CASE DESCRIPTION: The first patient was a 78-year-old woman with vertigo and vomiting lasting from waking up. Magnetic resonance imaging (MRI) and angiography documented right cerebellar infarction, and stenosis of the right cervical VA. Dynamic angiography revealed that the right VA was occluded when her neck was extended or rotated to the right...
February 2017: World Neurosurgery
https://www.readbyqxmd.com/read/27814312/impact-of-artifacts-on-vor-gain-measures-by-video-oculography-in-the-acute-vestibular-syndrome
#10
Georgios Mantokoudis, Ali S Saber Tehrani, Amy Wozniak, Karin Eibenberger, Jorge C Kattah, Cynthia I Guede, David S Zee, David E Newman-Toker
OBJECTIVE: The video head impulse test (HIT) measures vestibular function (vestibulo-ocular reflex [VOR] gain - ratio of eye to head movement), and, in principle, could be used to make a distinction between central and peripheral causes of vertigo. However, VOG recordings contain artifacts, so using unfiltered device data might bias the final diagnosis, limiting application in frontline healthcare settings such as the emergency department (ED). We sought to assess whether unfiltered data (containing artifacts) from a video-oculography (VOG) device have an impact on VOR gain measures in acute vestibular syndrome (AVS)...
November 3, 2016: Journal of Vestibular Research: Equilibrium & Orientation
https://www.readbyqxmd.com/read/27798932/clinical-presentation-magnetic-resonance-angiography-ultrasound-findings-and-stroke-patterns-in-patients-with-vertebral-artery-dissection
#11
Albrecht Günther, Otto W Witte, Martin Freesmeyer, Robert Drescher
BACKGROUND/AIMS: Vertebral artery dissection (VAD) is an important cause of ischemic stroke. In this observational study, clinical data, magnetic resonance (MR) and ultrasound (US) imaging findings and ischemic patterns were analyzed. METHODS: Forty-seven patients with a diagnosis of VAD underwent clinical examination, US, MR of the brain and neck and MR angiography (MRA) of the cervical arteries. Vascular abnormalities and ischemic brain lesions were noted. Data were evaluated separately and compared for spontaneous and traumatic VAD subgroups...
2016: European Neurology
https://www.readbyqxmd.com/read/27746083/vertebral-artery-hypoplasia-and-posterior-circulation-infarction-in-patients-with-isolated-vertigo-with-stroke-risk-factors
#12
Dao Pei Zhang, Gui Feng Lu, Jie Wen Zhang, Shu Ling Zhang, Qian Kun Ma, Suo Yin
BACKGROUND: We aimed in this study to investigate the prevalence of vertebral artery hypoplasia (VAH) in a population with isolated vertigo in association with stroke risk factors, to determine whether VAH is an independent risk factor for posterior circulation infarction (PCI). METHODS: We sequentially enrolled 245 patients with isolated vertigo with at least 1 vascular risk factor, who were divided into PCI and non-PCI groups, according to present signs of acute infarction on diffusion-weighted magnetic resonance imaging...
October 13, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/27638081/ischemic-syndromes-causing-dizziness-and-vertigo
#13
REVIEW
K-D Choi, H Lee, J-S Kim
Dizziness/vertigo and imbalance are the most common symptoms of vertebrobasilar ischemia. Even though dizziness/vertigo usually accompanies other neurologic symptoms and signs in cerebrovascular disorders, a diagnosis of isolated vascular vertigo is increasing markedly by virtue of recent developments in clinical neurotology and neuroimaging. It is important to differentiate isolated vertigo of a vascular cause from more benign disorders involving the inner ear, since therapeutic strategies and prognosis differ between these two conditions...
2016: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/27638064/vestibular-symptoms-and-history-taking
#14
REVIEW
A Bisdorff
History taking is an essential part in the diagnostic process of vestibular disorders. The approach to focus strongly on the quality of symptoms, like vertigo, dizziness, or unsteadiness, is not that useful as these symptoms often coexist and are all nonspecific, as each of them may arise from vestibular and nonvestibular diseases (like cardiovascular disease) and do not permit to distinguish potentially dangerous from benign causes. Instead, patients should be categorized if they have an acute, episodic, or chronic vestibular syndrome (AVS, EVS, or CVS) to narrow down the spectrum of differential diagnosis...
2016: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/27610119/advances-in-the-pathogenesis-diagnosis-and-treatment-of-bow-hunter-s-syndrome-a-comprehensive-review-of-the-literature
#15
REVIEW
Guangxin Duan, Jiaping Xu, Jijun Shi, Yongjun Cao
Bow hunter's syndrome (BHS), also known as rotational vertebral artery (VA) occlusion syndrome, is a rare yet treatable type of symptomatic vertebrobasilar insufficiency resulting from mechanical occlusion or stenosis of the VA during head and neck rotation or extension. The symptoms of BHS range from transient vertigo to posterior circulation stroke. The underlying pathology is dynamic stenosis or compression of the VA by abnormal bony structures with neck rotation or extension in many cases, such as osteophyte, disc herniation, cervical spondylosis, tendinous bands or tumors...
June 2016: Interventional Neurology
https://www.readbyqxmd.com/read/27608839/development-of-a-new-stroke-scale-in-an-emergency-setting
#16
Haifeng Mao, Peiyi Lin, Junrong Mo, Yunmei Li, Xiaohui Chen, Timothy H Rainer, Huilin Jiang
BACKGROUND: Early identification of stroke is crucial to maximize early management benefits in emergency departments. This study aimed to develop and validate a new stroke recognition instrument for differentiating acute stroke from stroke mimics in an emergency setting. METHODS: A prospective observational cohort study among suspected stroke patients presenting to Emergency Department in the Second Affiliated Hospital of Guangzhou Medical University was conducted from May 2012 to March 2013...
September 8, 2016: BMC Neurology
https://www.readbyqxmd.com/read/27599806/sinking-flap-syndrome-with-abdominal-pain-an-atypical-presentation
#17
Isabelle Beuchat, Patrik Michel, Philippe Maeder, Karin Diserens
UNLABELLED: A 53-year-old man developed significant mass effect secondary to an ischaemic stroke and was treated with decompressive craniectomy. During the first few days postsurgery he developed orthostatic vertigo with nausea. After a month, with increasing mobilisation and rehabilitation, he started reporting of severe abdominal pain. No aetiology could be found despite extensive local work up and the symptoms were resistant to any symptomatic treatment. Within days postcranioplasty there was a complete resolution of all the symptoms...
September 6, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27495834/how-commonly-is-stroke-found-in-patients-with-isolated-vertigo-or-dizziness-attack
#18
Ryosuke Doijiri, Hisakazu Uno, Kotaro Miyashita, Masafumi Ihara, Kazuyuki Nagatsuka
BACKGROUND: The sudden development of vertigo or dizziness without focal neurological symptoms is generally attributable to vestibular diseases such as benign paroxysmal positional vertigo. Isolated vertigo or dizziness attack needs more attention than vestibular diseases. This retrospective study was performed to elucidate the frequency of strokes in patients with isolated vertigo or dizziness attack. SUBJECTS AND METHODS: We enrolled 221 patients (men, 119; women, 102; mean age, 68...
October 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/27430449/vertigo-and-hearing-loss
#19
REVIEW
David E Newman-Toker, Charles C Della Santina, Ari M Blitz
Symptoms referable to disorders affecting the inner ear and vestibulocochlear nerve (eighth cranial nerve) include dizziness, vertigo, tinnitus, and hearing loss, in various combinations. Similar symptoms may occur with involvement of the central nervous system, principally the brainstem and cerebellum, to which the vestibular and auditory systems are connected. Imaging choices should be tailored to patient symptoms and the clinical context. Computed tomography (CT) should be used primarily to assess bony structures...
2016: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/27255679/utilizing-dual-energy-ct-to-improve-ct-diagnosis-of-posterior-fossa-ischemia
#20
H R Hixson, C Leiva-Salinas, S Sumer, J Patrie, W Xin, M Wintermark
BACKGROUND AND PURPOSE: Evaluation of posterior fossa ischemia on conventional CT is limited. The goal of our study was to determine if virtual monochromatic CT increases the diagnostic accuracy for the detection of posterior infarcts relative to standard CT while using diffusion-weighted MRI as a reference standard. METHODS: Thirty consecutive subjects who meet the following inclusion criteria were retrospectively enrolled: (1) symptoms of posterior fossa stroke (e...
October 2016: Journal of Neuroradiology. Journal de Neuroradiologie
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