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Evidences of vascular origin of cochleovestibular dysfunction
A Szirmai1, M Küstel, G Pánczél
1Semmelweis University, Budapest, Department of Otolaryngology and Head and Neck Surgery, H-1083, Szigony u 36, Budapest, Hungary. szirmai@fulo.sote.hu
Insights
Diagnosing cochleovestibular vascular disorders involves excluding other conditions and identifying vascular risk factors. Imaging and audiological tests help confirm vascular origins when other causes are ruled out.
Area of Science:
- Neurology
- Otolaryngology
- Vascular Medicine
Background:
- Diagnosing cochleovestibular vascular disorders is challenging due to the inability to directly visualize affected arteries.
- Diagnosis relies on excluding other conditions and inferring vascular involvement from risk factors and lesions in other areas.
- Vascular risk factors are crucial indicators for suspected cochleovestibular vascular disease.
Purpose of the Study:
- To investigate the diagnostic criteria for cochleovestibular vascular disorders.
- To evaluate the utility of various diagnostic methods in identifying vascular origins of vertigo.
- To establish a framework for diagnosing vascular-related cochleovestibular dysfunction.
Main Methods:
- Analysis of data from 19 patients presenting with vertigo.
- Comprehensive evaluations including detailed blood tests, neurootological and audiological examinations.
- Advanced imaging techniques such as carotid and vertebral artery Doppler sonography, Magnetic Resonance Imaging (MRI), and Magnetic Resonance Angiography (MRA).
Main Results:
- Abnormalities in cochleovestibular examination and Auditory Brainstem Response (ABR) were observed in 73.7% of patients.
- Vascular abnormalities detected by Doppler sonography or MRI occurred in 57.9% of cases.
- Magnetic Resonance Angiography (MRA) revealed abnormalities in 47.4% of patients, with most exhibiting multiple cerebrovascular risk factors.
Conclusions:
- Cochleovestibular disorders are considered vascular in origin when other diseases are excluded.
- The presence of vascular risk factors is a key diagnostic indicator.
- Evidence of vascular disorders in other brain territories, detectable via imaging, supports a vascular diagnosis for cochleovestibular issues.
Objectives:
When the vascular disorder of the cochleovestibular system is mentioned, the diagnosis is based on exclusion of other diseases. Since arteries of the cochleovestibular system cannot be directly visualized, physicians must deduce from the vascular risk factors and the vascular lesion of other territories to the vascular cochleovestibular disease.
Materials And Methods:
Authors analyzed the data of 19 patients with vertigo. Detailed blood tests, complete neurootological and audiological examination including ABR, carotid and vertebral artery Doppler sonography, MRI and MRA was performed.
Results:
Cochleovestibular examination and ABR showed abnormalities in 73.7%, either carotid and vertebral artery Doppler or MRI showed abnormalities in 57.9%. MRA was abnormal in 47.4%. In most of the patients multiple risk factors of cerebrovascular disorder could be found.
Conclusions:
The cochleovestibular system disorders can be considered to be of vascular origin if the examinations exclude other diseases, if the patients have vascular risk factors and if other territories of brain accessible for imaging methods show vascular disorders.