Stroke and peripheral vestibulopathy as a part of acute vestibular syndrome
The scope of the review is the problem of differential diagnosis between stroke and peripheral vestibulopathy in patients with acute vestibular vertigo. A vertebrobasilar stroke manifesting with the isolated vertigo has been previously recognized to be extremely rare, and the symptoms have been rela...
| Main Author: | |
|---|---|
| Format: | Article |
| Language: | Russian |
| Published: |
MONIKI
2023-05-01
|
| Series: | Alʹmanah Kliničeskoj Mediciny |
| Subjects: | |
| Online Access: | https://almclinmed.ru/jour/article/viewFile/5549/1548 |
| _version_ | 1827949291844403200 |
|---|---|
| author | Elena V. Isakova |
| author_facet | Elena V. Isakova |
| author_sort | Elena V. Isakova |
| collection | DOAJ |
| description | The scope of the review is the problem of differential diagnosis between stroke and peripheral vestibulopathy in patients with acute vestibular vertigo. A vertebrobasilar stroke manifesting with the isolated vertigo has been previously recognized to be extremely rare, and the symptoms have been related to the involvement of peripheral parts of the vestibular analyzer. Recently there has been growing evidence that the isolated vertigo syndrome is commonly related to the central involvement of the vestibular analyzer. The author presents published clinical cases of acute cerebrovascular accident with a single symptom of acute vestibular vertigo. It can be also a symptom of a hemispheric stroke due to an injury of vestibular pathways connecting the vestibular nuclei with the parietal cortex. These observations extend the understanding of the common classic pathognomonic picture of central vestibular vertigo, which implies that its development is related exclusively to the brain matter lesion in vestibulobasilar stroke.
Current clinical rating scales and tests (NIHSS, FAST) used for the diagnosis of an acute stroke, are frequently not sensitive to the vertebrobasilar stroke, and neuroimaging, including brain magnetic resonance imaging at DWI mode, may give false negative results. The most informative differential diagnostic method in acute vestibular syndrome is an otoneurological assessment including identification of nystagmus characteristics and head turn impulse test, for the assessment of vestibuloocular reflex and at bed tests (for example, tests included into the HINTS PLUS protocol). In this regard, it is important that neurology specialists in regional vascular centers and departments for acute cerebrovascular care should master the otoneurological assessment skills. |
| first_indexed | 2024-04-09T13:08:09Z |
| format | Article |
| id | doaj.art-8de4b8acbf7743fb90dfea4e37c9749a |
| institution | Directory Open Access Journal |
| issn | 2072-0505 2587-9294 |
| language | Russian |
| last_indexed | 2024-04-09T13:08:09Z |
| publishDate | 2023-05-01 |
| publisher | MONIKI |
| record_format | Article |
| series | Alʹmanah Kliničeskoj Mediciny |
| spelling | doaj.art-8de4b8acbf7743fb90dfea4e37c9749a2023-05-12T10:29:47ZrusMONIKIAlʹmanah Kliničeskoj Mediciny2072-05052587-92942023-05-01511142210.18786/2072-0505-2023-51-003921Stroke and peripheral vestibulopathy as a part of acute vestibular syndromeElena V. Isakova0https://orcid.org/0000-0002-0804-1128Moscow Regional Research and Clinical Institute (MONIKI)The scope of the review is the problem of differential diagnosis between stroke and peripheral vestibulopathy in patients with acute vestibular vertigo. A vertebrobasilar stroke manifesting with the isolated vertigo has been previously recognized to be extremely rare, and the symptoms have been related to the involvement of peripheral parts of the vestibular analyzer. Recently there has been growing evidence that the isolated vertigo syndrome is commonly related to the central involvement of the vestibular analyzer. The author presents published clinical cases of acute cerebrovascular accident with a single symptom of acute vestibular vertigo. It can be also a symptom of a hemispheric stroke due to an injury of vestibular pathways connecting the vestibular nuclei with the parietal cortex. These observations extend the understanding of the common classic pathognomonic picture of central vestibular vertigo, which implies that its development is related exclusively to the brain matter lesion in vestibulobasilar stroke. Current clinical rating scales and tests (NIHSS, FAST) used for the diagnosis of an acute stroke, are frequently not sensitive to the vertebrobasilar stroke, and neuroimaging, including brain magnetic resonance imaging at DWI mode, may give false negative results. The most informative differential diagnostic method in acute vestibular syndrome is an otoneurological assessment including identification of nystagmus characteristics and head turn impulse test, for the assessment of vestibuloocular reflex and at bed tests (for example, tests included into the HINTS PLUS protocol). In this regard, it is important that neurology specialists in regional vascular centers and departments for acute cerebrovascular care should master the otoneurological assessment skills.https://almclinmed.ru/jour/article/viewFile/5549/1548dizzinessvestibular vertigoisolated vestibular vertigostroke in the vertebrobasilar basin |
| spellingShingle | Elena V. Isakova Stroke and peripheral vestibulopathy as a part of acute vestibular syndrome Alʹmanah Kliničeskoj Mediciny dizziness vestibular vertigo isolated vestibular vertigo stroke in the vertebrobasilar basin |
| title | Stroke and peripheral vestibulopathy as a part of acute vestibular syndrome |
| title_full | Stroke and peripheral vestibulopathy as a part of acute vestibular syndrome |
| title_fullStr | Stroke and peripheral vestibulopathy as a part of acute vestibular syndrome |
| title_full_unstemmed | Stroke and peripheral vestibulopathy as a part of acute vestibular syndrome |
| title_short | Stroke and peripheral vestibulopathy as a part of acute vestibular syndrome |
| title_sort | stroke and peripheral vestibulopathy as a part of acute vestibular syndrome |
| topic | dizziness vestibular vertigo isolated vestibular vertigo stroke in the vertebrobasilar basin |
| url | https://almclinmed.ru/jour/article/viewFile/5549/1548 |
| work_keys_str_mv | AT elenavisakova strokeandperipheralvestibulopathyasapartofacutevestibularsyndrome |