[Vestibular vertigo in stroke and vestibular neuronitis]

Area of Science:

• Neurology
• Otolaryngology

Background:

• Acute vestibular syndrome presents diagnostic challenges, with vertebrobasilar ischemic stroke and vestibular neuritis being primary causes.
• Understanding the clinical features associated with specific cerebral infarction locations and vestibular neuritis is essential.

Purpose of the Study:

• To delineate the differential diagnosis of acute vestibular dizziness.
• To present treatment and diagnostic algorithms for acute vestibular syndrome based on etiology.

Main Methods:

• Review of clinical characteristics of vestibular neuritis.
• Analysis of acute vestibular syndrome features based on cerebral infarction localization (cerebellar and brain stem arteries).
• Discussion of diagnostic tools like nystagmus and head impulse test.

Main Results:

• Cerebral infarction in specific arterial territories (PI, AI, SCAs) and brain stem presents distinct vestibular syndrome features.
• Vestibular neuritis exhibits detailed clinical characteristics that aid in differentiation.
• Nystagmus and head impulse test are key in differential diagnosis.

Conclusions:

• Accurate otoneurological examination is fundamental for neurologists to distinguish between vestibular neuritis and vertebrobasilar stroke.
• Individualized treatment approaches are necessary, dictated by the underlying cause of acute vestibular syndrome.