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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
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Vestibular symptoms in acute hemispheric strokes.
Shuichiro Eguchi1, Genjiro Hirose2, Miho Miaki1
1Department of Neurology, Neurological Center, Asanogawa General Hospital, Naka 83, Kosaka-machi, Kanazawa, 920-8621, Ishikawa, Japan.
Journal of Neurology
|May 1, 2019
Summary
Acute hemispheric strokes can cause vestibular symptoms, particularly when lesions affect the right hemisphere's vestibular cortical network. Isolated parieto-insular vestibular cortex (PIVC) or temporo-periSylvian vestibular cortex (TPSVC) lesions may not induce vertigo.
Area of Science:
- Neurology
- Neuroscience
- Vascular Neurology
Background:
- Vestibular symptoms like vertigo are common but their origin in acute hemispheric stroke requires clarification.
- The role of specific brain regions, such as the parieto-insular vestibular cortex (PIVC) and temporo-periSylvian vestibular cortex (TPSVC), in stroke-induced vestibular dysfunction is not fully understood.
Purpose of the Study:
- To investigate the occurrence, frequency, and lesion lateralization of vestibular symptoms in patients with acute hemispheric strokes.
- To determine if lesions confined to the PIVC or TPSVC cause vestibular symptoms.
Main Methods:
- Prospective study of 668 patients with hemispheric infarction, identifying those with acute vestibular symptoms (VS group).
- Retrospective review of MRI scans for all stroke patients to identify lesions in the PIVC or TPSVC (PIVC group).
- Comparison of clinical presentation and MRI findings between the VS and PIVC groups.
Main Results:
- Eight patients were identified in the VS group; six had right-hemisphere lesions, primarily in the middle cerebral artery (MCA) territory, affecting areas including the insula and temporal lobe.
- Six patients were identified in the PIVC group, none of whom experienced vestibular symptoms.
- Lesions in the PIVC group were located in the insular and temporal lobes, with a slight predominance in the left hemisphere.
Conclusions:
- Cerebral hemispheric infarction limited to the PIVC or TPSVC does not invariably lead to vertigo.
- Unilateral hemispheric infarctions within the vestibular cortical network can cause vestibular symptoms.
- Lesions responsible for vestibular symptoms in hemispheric stroke are more frequently located in the right hemisphere.
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