Progress in the Study of Diagnostic Methods for Central Acute Vestibular Syndrome of a Vascular Cause

Acute vestibular syndrome (AVS) is characterized by the sudden onset of dizziness or vertigo, accompanied by nausea, vomiting, gait instability, and nystagmus, lasting for more than 24 hours and often persisting for several days to weeks. Central AVS primarily involves central vestibular structures, such as the brainstem and cerebellum, and is most commonly caused by ischemic stroke in the posterior circulation. When acute posterior circulation infarction presents solely with isolated dizziness or vertigo, without other symptoms of central nervous system damage, it is often misdiagnosed as a peripheral vestibular disorder, this can lead to serious consequences. Therefore, distinguishing between central AVS and peripheral AVS in clinical practice is crucial, as the treatment strategies and prognosis differ significantly. Early identification of central AVS helps in adopting specific diagnostic and therapeutic measures. With advancements in vestibular and oculomotor theories, as well as neuroimaging, it is now possible to rapidly identify and diagnose central AVS of a vascular cause. This article summarizes recent diagnostic strategies, and discusses the progress in clinical and laboratory examinations for central AVS of a vascular cause presenting as isolated vertigo.