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Vertigo, stroke

Jeffrey R Hebert, Prem S Subramanian
PURPOSE OF REVIEW: Disorders of posture and balance cause significant patient morbidity, with reduction of quality of life as patients refrain from critical activities of daily living such as walking outside the home and driving. This review describes recent efforts to characterize visual disorders that interact with the neural integrators of positional maintenance and emerging therapies for these disorders. RECENT FINDINGS: Abnormalities of gait and body position sense may be unrecognized by patients but are correlated with focal neurological injury (stroke)...
March 16, 2019: Current Neurology and Neuroscience Reports
Jaroslav Michalek, Alena Vrablikova, Karl Georg Heinrich, Zuzana Dudasova
A 48-year-old male, who suffered from a stroke resulting in cerebellum damage and occlusion of the left vertebral artery, underwent stromal vascular fraction therapy. The clinical status of the patient was monitored by a modified Stroke Specific Quality of Life Scale before therapy and at 3, 9, 12, 18, 24, and 32 months after therapy. Three months after therapy, the patient felt a reduction in pain, vertigo, and fatigue. After 9 months, he was able to walk safely on his own. After 24 months, he was able to ride a bicycle...
March 6, 2019: Brain Sciences
James E McKinley, Allen Perkins
Dizziness is seen frequently in patients in the family medicine and emergency department settings. The differential diagnosis of dizziness can be expansive but with a targeted history and physical examination, a correct diagnosis often can be established and appropriate treatment offered. Common etiologies of dizziness include hypotension, benign paroxysmal positional vertigo (BPPV), and Meniere disease. Strokes and malignancies also can cause this symptom. Imaging is indicated if intracranial pathology is suspected...
February 2019: FP Essentials
Kiersten L Gurley, Jonathan A Edlow
Dizziness is a common chief complaint with an extensive differential diagnosis that includes both benign and serious conditions. Physicians must distinguish the majority of patients who suffer from self-limiting conditions from those with serious illnesses that require acute treatment. The preferred approach to the diagnosis of an acutely dizzy patient emphasizes different aspects of the history to guide a focused physical examination, with the goal of differentiating benign peripheral vestibular conditions from dangerous posterior circulation strokes...
February 2019: Seminars in Neurology
(no author information available yet)
Vestibular migraine (VM) is a common disorder characterized by recurrent dizziness and/or vertigo, which involves a number of specialites and is easily misdiagnosed. The Stroke and Vertigo Association of Chinese Stroke Association and Vertigo Professional Committee of Neurology Branch of Chinese Physicians Association organized multi-disciplinary experts to discuss clinical issues of VM. The purpose of this consensus is to establish a standard framework for the diagnosis and management of VM in China.
February 1, 2019: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
Yuichiro Yoneoka, Ryo Ikeda, Naotaka Aizawa, Yasuhiro Seki, Katsuhiko Akiyama
In this report, we describe unilateral medial pontomedullary junction (MPMJ) syndrome as a novel brain stem stroke syndrome. A 68-year-old woman suddenly developed vertigo, ipsilateral facial paresis, contralateral thermal hypoalgesia (TH) and dysphagia without lateral gaze palsy, curtain sign and hoarseness. Magnetic resonance (MR) imaging showed a small infarction at the right MPMJ. MR angiography did not show vertebrobasilar arterial dissection, thrombosis or vasospasm. Finally, her dysphagia regressed over 4 weeks in synchronization with recovery of TH...
January 2019: Oxford Medical Case Reports
Jung-Yup Lee, Chang-Hee Kim, Jin Su Park, Min-Beom Kim
OBJECTIVE: To analyze acute vertigo showing spontaneous nystagmus with negative video head impulse test (vHIT). STUDY DESIGN: Retrospective chart analysis. SETTING: Tertiary referral hospital. SUBJECTS AND METHODS: Over 16 months, 155 patients were identified with acute vertigo with spontaneous nystagmus. Of these 155, 30 (19.4%) were enrolled in this study because they did not show gain loss or catch-up saccades in both sides of the horizontal vHIT...
January 22, 2019: Otolaryngology—Head and Neck Surgery
Giulia Cossu, Louis-Marie Terrier, Christophe Destrieux, Stephane Velut, Patrick François, Ilyess Zemmoura, Aymeric Amelot
PURPOSE: The groove of the vertebral artery on the posterior arch of the atlas (sulcus arteriae vertebralis) may become a complete or partial osseous foramen: the arcuate foramen. The presence of a complete or partial arcuate foramen is a rare anatomical variant described in a minority of patients and it seems to be associated with vertigo, vertebro-basilar insufficiency, posterior circulation strokes, and musculoskeletal pain. As the number and morphology of cervical vertebrae is highly preserved, we questioned about its significance from an evolutionary point of view...
January 17, 2019: Surgical and Radiologic Anatomy: SRA
Narushi Sugii, Alexander Zaboronok, Hiroyuki Fujimori, Naoaki Sato, Keishi Fujita, Eiichi Ishikawa, Akira Matsumura
BACKGROUND: Stroke mimics (SMs)are medical conditions that are at first considered to be of cerebrovascular etiology but turn out to be a condition other than stroke. While many reports on SMs have been published, there have been none from Japan. Thus, we sought to assess the current state of SMs in a Japanese population. METHODS: We collected data of patients referred with suspicion of stroke to neurosurgeons by emergency department (ED) doctors, and we retrospectively evaluated the diagnosis concordance rate between the ED doctors and the neurosurgeons...
January 9, 2019: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
(no author information available yet)
No abstract text is available yet for this article.
January 20, 2019: Chinese Medical Journal
Dorota Kozera-Strzelińska, Michał Karliński, Grzegorz Rak, Magdalena Wojdacz, Halina Sienkiewicz-Jarosz, Iwona Kurkowska-Jastrzębska
INTRODUCTION: Our aim was to compare the structure and management of conditions mimicking acute cerebrovascular events (ACE) defined as stroke or transient ischemic attack between patients referred directly to neurological emergency department (ED) by non-ambulance physicians, ambulance physicians and paramedics. METHODS: It is a retrospective study of 802 consecutive patients referred to a Polish urban neurological ED with prehospital suspicion of ACE between January and December 2014...
January 7, 2019: Neurologia i Neurochirurgia Polska
(no author information available yet)
[This corrects the article DOI: 10.3389/fneur.2018.00974.].
2018: Frontiers in Neurology
William J Meurer, Kathryn E Beck, Brigid Rowell, Devin Brown, Alexander Tsodikov, Angela Fagerlin, Steven A Telian, Laura Damschroder, Lawrence C An, Lewis B Morgenstern, Misty Ujhely, Laura Loudermilk, Sandeep Vijan, Kevin A Kerber
BACKGROUND: Benign paroxysmal positional vertigo (BPPV) is the most common peripheral vestibular disorder, and accounts for 8% of individuals with moderate or severe dizziness. BPPV patients experience substantial inconveniences and disabilities during symptomatic periods. BPPV therapeutic processes - the Dix-Hallpike Test (DHT) and the Canalith Repositioning Maneuver (CRM) - have an evidence base that is at the clinical practice guideline level. The most commonly used CRM is the modified Epley maneuver...
December 22, 2018: Trials
Yan Fang Peng, Huai Liang Zhang, Dao Pei Zhang, Min Zhao, Shu Ling Zhang, Suo Yin
Objective: To investigate the association between the perfusion magnetic resonance imaging (MRI) and vertebrobasilar dolichoectasia (VBD) in vertigo patients and at least one vascular risk factor. Methods: We studied 289 patients with vertigo (spinning, swaying, nausea, vomiting, and unsteady gait) who performed multimode MRI. Maximum diameter and tortuous parameters of the basilar artery and vertebral arteries were calculated using magnetic resonance angiography...
December 2018: Annals of Clinical and Translational Neurology
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
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