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Case Report
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A Rare Case of Isolated Infarcts of the Pons with Sudden Vertigo: Clinical Features and Imaging Findings
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Dong Hwan Kwon, Eun kyung Jeon, Young Joon Seo
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Res Vestib Sci. 2023;22(3):89-94. Published online September 15, 2023
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DOI: https://doi.org/10.21790/rvs.2023.22.3.89
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Abstract
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- Isolated infarcts of the pons (IIP) are a rare subtype of ischemic stroke, accounting for less than 1% of all strokes. It refers to a specific type of ischemic stroke that occurs within the pons region of the brain. IIP can be associated with vertebrobasilar insufficiency in certain cases. This case report describes a 64-year-old female patient who presented with acute vertigo and spontaneous nystagmus to the lesion side, ultimately diagnosed with IIP in the posterior right side of pons. Tegmental pontine infarcts typically manifest as oblique small (lacunar) infarctions that are localized in the mediolateral tegmental area of the middle to upper pons. The patient’s symptoms resolved spontaneously, but a 2-mm infarct was confirmed by brain diffusion magnetic resonance imaging. This case highlights the distinctive symptoms associated with IIP and emphasizes the importance of careful neurological examination and advanced neuroimaging techniques for accurate diagnosis.
Review
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Functional Neuroimaging in Neuro-Otology
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Jae Jin Song
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Res Vestib Sci. 2016;15(1):5-10.
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Abstract
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- Neuro-otologic symptoms such as dizziness, hearing loss, or tinnitus give rise to
peripheral change-induced neuroplasticity or central pathology-induced structural
or functional changes. In this regard, functional neuroimaging modalities such as
positron emission tomography (PET), functional magnetic resonance imaging
(fMRI), magnetoencephalography (MEG), quantitative electroencephalography
(qEEG), or functional near infrared spectroscopy have provided researchers with
possibility to observe neuro-otologic disease-induced central functional changes.
Among these methods, PET and fMRI are advantageous over qEEG or MEG
with regard to spatial resolution, while qEEG and MEG are advantageous over
PET or fMRI with regard to temporal resolution. Also, fMRI or MEG is not
suitable for patients with implanted devices, whereas PET is not ideal for
repetitive measures due to radiation hazard. In other words, as these modalities
are complementary to one another, researchers should choose optimum imaging
modality on a case by case basis. Hereinafter, representative functional neuroimaging
modalities and their application to neuro-otologic research will be
summarized.