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Research in Vestibular Science > Volume 9(1); 2010 > Article
Research in Vestibular Science 2010;9(1): 12-15.
고립성 현훈 환자에서 급성기 뇌경색
남정무, 정규리, 이정주, 박종무, 구자성, 권오현, 김병건
을지대학교 의과대학 을지병원 신경과
Acute Stroke in Patients With Isolated Vertigo
Jungmoo Nam, Curie Chung, Jung Ju Lee, Jong Moo Park, Ja Seong Koo, Ohyun Kwon, Byung Kun Kim
Department of Neurology, Eulji General Hospital, Eulji University College of Medicine, Seoul, Korea. kbk1403@eulji.ac.kr
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. ConclusionIsolated 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.
Keywords: Vertigo; Diffusion weighted MRI; Cerebral infarction
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