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KMID : 1235520100090010012
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Research in Vestibular Science
2010 Volume.9 No. 1 p.12 ~ p.15
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Acute Stroke in Patients With Isolated Vertigo
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Nam Jung-Moo
Park Jong-Moo
Kwon O-Hyun
Koo Ja-Seong
Kim Byung-Kun
Lee Jung-Ju
Chung Cu-Rie
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Abstract
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Background and Objectives:Patients with isolated vertigo could have central or peripheral vestibular disorders. Although some differential points exist between the two conditions, sometimes it is not easy to differentiate central vertigo from that of peripheral vestibular origin, especially in patients with isolated vertigo. We performed this study to determine the frequency of acute infarction and predictors of vertigo associated with stroke in isolated spontaneous vertigo. Materials and
Methods:We prospectively evaluated 185 consecutive patients who were admitted to neurology department with acute isolated vertigo, after excluding the patients with benign paroxysmal positioning vertigo. Diffusion-weighted MRI (DWI) was obtained in 161 (87.0%) patients. Demographics, stroke risk factors, associated symptoms and signs were reviewed. Also, the locations and vascular territories of the lesions on DWI were investigated.
Results:Twenty three (14.3%) patients had acute infarction on DWI. Old age and male sex were the predictors of stroke using multivariate analysis (p=0.03 and 0.02). The lesions were located in the cerebellum in 17 patients, medulla in four, and pons in another four. Cerebellar lesions were in the territory of the posterior inferior cerebellar artery in all patients.
Conclusion:Isolated spontaneous vertigo may develop in posterior circulation stroke, especially in men of old age. The possibility of central origin should be considered in patients with isolated vertigo and DWI might be a good diagnostic tool.
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KEYWORD
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Vertigo, Diffusion weighted MRI, Cerebral infarction
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