Cerebral Small Vessel Disease in Elderly Patients With Vestibular Neuritis
BackgroundAcute audiovestibular loss is a neurotologic emergency of which the etiology is frequently unknown. In vestibular neuritis a viral genesis is expected, although there is insufficient evidence to support viruses as the only possible etiological factor. In sudden deafness, a vascular etiolog...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-03-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2022.818533/full |
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| author | Fieke K. Oussoren Fieke K. Oussoren Louise N. F. Poulsen Joost J. Kardux Tjard R. Schermer Tjasse D. Bruintjes Tjasse D. Bruintjes Roeland B. van Leeuwen |
| author_facet | Fieke K. Oussoren Fieke K. Oussoren Louise N. F. Poulsen Joost J. Kardux Tjard R. Schermer Tjasse D. Bruintjes Tjasse D. Bruintjes Roeland B. van Leeuwen |
| author_sort | Fieke K. Oussoren |
| collection | DOAJ |
| description | BackgroundAcute audiovestibular loss is a neurotologic emergency of which the etiology is frequently unknown. In vestibular neuritis a viral genesis is expected, although there is insufficient evidence to support viruses as the only possible etiological factor. In sudden deafness, a vascular etiology has been proposed in elderly patients, since cardiovascular risk factors are more frequently present and a higher risk of developing a stroke was seen compared to the general population. So far, very little research has been carried out on vascular involvement in elderly patients with vestibular neuritis. Cardiovascular risk factors have a positive correlation with cerebral small vessel disease, visible as white matter hyperintensities, brain infarctions, microbleeds and lacunes on MRI. The presence of these characteristics indicate a higher risk of developing a stroke.AimWe investigated whether elderly patients with vestibular neuritis have a higher prevalence of vascular lesions on MRI compared to a control cohort.Materials and MethodsPatients of 50-years and older, diagnosed with vestibular neuritis in a multidisciplinary tertiary referral hospital, were retrospectively reviewed and compared to a control cohort. The primary outcome was the difference in cerebral small vessel disease on MRI imaging, which was assessed by the number of white matter hyperintensities using the ordinal Fazekas scale. Secondary outcomes were the presence of brain infarctions on MRI and the difference in cardiovascular risk factors.ResultsPatients with vestibular neuritis (N = 101) had a 1.60 higher odds of receiving a higher Fazekas score than the control cohort (N = 203) (p = 0.048), there was no difference in presence of brain infarctions (p = 1.0). Hyperlipidemia and atrial fibrillation were more common in patients experiencing vestibular neuritis.ConclusionWe found a positive correlation of white matter hyperintensities and VN which supports the hypothesis of vascular involvement in the pathophysiology of vestibular neuritis in elderly patients. Further prospective research is necessary to confirm this correlation. |
| first_indexed | 2024-04-13T19:49:36Z |
| format | Article |
| id | doaj.art-e0c056ba0acf4b81b0a05d14cfa9b04a |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-04-13T19:49:36Z |
| publishDate | 2022-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-e0c056ba0acf4b81b0a05d14cfa9b04a2022-12-22T02:32:36ZengFrontiers Media S.A.Frontiers in Neurology1664-22952022-03-011310.3389/fneur.2022.818533818533Cerebral Small Vessel Disease in Elderly Patients With Vestibular NeuritisFieke K. Oussoren0Fieke K. Oussoren1Louise N. F. Poulsen2Joost J. Kardux3Tjard R. Schermer4Tjasse D. Bruintjes5Tjasse D. Bruintjes6Roeland B. van Leeuwen7Apeldoorn Dizziness Centre, Gelre Hospital, Apeldoorn, NetherlandsDepartment of Otorhinolaryngology, Leiden University Medical Center, Leiden, NetherlandsDepartment of Radiology, Gelre Hospital, Apeldoorn, NetherlandsDepartment of Radiology, Gelre Hospital, Apeldoorn, NetherlandsApeldoorn Dizziness Centre, Gelre Hospital, Apeldoorn, NetherlandsApeldoorn Dizziness Centre, Gelre Hospital, Apeldoorn, NetherlandsDepartment of Otorhinolaryngology, Leiden University Medical Center, Leiden, NetherlandsApeldoorn Dizziness Centre, Gelre Hospital, Apeldoorn, NetherlandsBackgroundAcute audiovestibular loss is a neurotologic emergency of which the etiology is frequently unknown. In vestibular neuritis a viral genesis is expected, although there is insufficient evidence to support viruses as the only possible etiological factor. In sudden deafness, a vascular etiology has been proposed in elderly patients, since cardiovascular risk factors are more frequently present and a higher risk of developing a stroke was seen compared to the general population. So far, very little research has been carried out on vascular involvement in elderly patients with vestibular neuritis. Cardiovascular risk factors have a positive correlation with cerebral small vessel disease, visible as white matter hyperintensities, brain infarctions, microbleeds and lacunes on MRI. The presence of these characteristics indicate a higher risk of developing a stroke.AimWe investigated whether elderly patients with vestibular neuritis have a higher prevalence of vascular lesions on MRI compared to a control cohort.Materials and MethodsPatients of 50-years and older, diagnosed with vestibular neuritis in a multidisciplinary tertiary referral hospital, were retrospectively reviewed and compared to a control cohort. The primary outcome was the difference in cerebral small vessel disease on MRI imaging, which was assessed by the number of white matter hyperintensities using the ordinal Fazekas scale. Secondary outcomes were the presence of brain infarctions on MRI and the difference in cardiovascular risk factors.ResultsPatients with vestibular neuritis (N = 101) had a 1.60 higher odds of receiving a higher Fazekas score than the control cohort (N = 203) (p = 0.048), there was no difference in presence of brain infarctions (p = 1.0). Hyperlipidemia and atrial fibrillation were more common in patients experiencing vestibular neuritis.ConclusionWe found a positive correlation of white matter hyperintensities and VN which supports the hypothesis of vascular involvement in the pathophysiology of vestibular neuritis in elderly patients. Further prospective research is necessary to confirm this correlation.https://www.frontiersin.org/articles/10.3389/fneur.2022.818533/fullstrokevestibular neuritis (VN)MRIwhite matter hyper intensitiesvascular etiology |
| spellingShingle | Fieke K. Oussoren Fieke K. Oussoren Louise N. F. Poulsen Joost J. Kardux Tjard R. Schermer Tjasse D. Bruintjes Tjasse D. Bruintjes Roeland B. van Leeuwen Cerebral Small Vessel Disease in Elderly Patients With Vestibular Neuritis Frontiers in Neurology stroke vestibular neuritis (VN) MRI white matter hyper intensities vascular etiology |
| title | Cerebral Small Vessel Disease in Elderly Patients With Vestibular Neuritis |
| title_full | Cerebral Small Vessel Disease in Elderly Patients With Vestibular Neuritis |
| title_fullStr | Cerebral Small Vessel Disease in Elderly Patients With Vestibular Neuritis |
| title_full_unstemmed | Cerebral Small Vessel Disease in Elderly Patients With Vestibular Neuritis |
| title_short | Cerebral Small Vessel Disease in Elderly Patients With Vestibular Neuritis |
| title_sort | cerebral small vessel disease in elderly patients with vestibular neuritis |
| topic | stroke vestibular neuritis (VN) MRI white matter hyper intensities vascular etiology |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2022.818533/full |
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