PMID- 32689600
OWN - NLM
STAT- MEDLINE
DCOM- 20201030
LR  - 20201030
IS  - 1532-8511 (Electronic)
IS  - 1052-3057 (Linking)
VI  - 29
IP  - 8
DP  - 2020 Aug
TI  - Vestibular nuclear infarction: Case series and review of the literature.
PG  - 104937
LID - S1052-3057(20)30343-8 [pii]
LID - 10.1016/j.jstrokecerebrovasdis.2020.104937 [doi]
AB  - BACKGROUND AND PURPOSE: Acute vestibular syndrome (AVS) is a common cause of 
      emergency admittance and has very rarely been reported due to a vestibular 
      nucleus infarction. Initial magnetic resonance imaging studies (MRIs) including 
      diffusion-weighted images may reveal normal results and even bedside examination 
      tests like HINTS battery which involves head impulse test (HIT), nystagmus and 
      test of skew can be challenging in differing a peripheral vestibulopathy from a 
      central lesion. METHODS: Four patients seen in the emergency department with AVS 
      and evaluated with HINTS battery, cervical vestibular-evoked myogenic potentials 
      (cVEMP) and cranial MRI revealing infarcts restricted to vestibular nuclei were 
      evaluated. RESULTS: In two patients spontaneous nystagmus beating towards the 
      unaffected side was present. In one patient spontaneous nystagmus changed 
      direction on looking to the affected side. In the fourth gaze evoked nystagmus 
      was present without any spontaneous nystagmus. In all, HIT was positive to the 
      affected side. In three cVEMPs was studied revealing delayed latency, reduced 
      amplitude p13/n23 potentials on the lesioned side in two of them. Initial MRIs 
      including diffusion-weighted images disclosed acute infarction in the area of the 
      vestibular nuclei in two patients, with normal results in the other two. 
      Follow-up MRI's performed 48 hours later revealed vestibular nuclear infarction. 
      CONCLUSION: It is not always easy to differentiate small lesions restricted to 
      central vestibular structures from peripheral vestibular lesions both on clinical 
      and radiological grounds. Follow-up cranial MRI is necessary in patients with 
      known vascular risk factors.
CI  - Copyright (c) 2020 Elsevier Inc. All rights reserved.
FAU - Atac, Ceyla
AU  - Atac C
AD  - Ceyla Atac, Izmir Bozyaka Egitim ve Arastirma Hastanesi, Neurology, 35360 Izmir, 
      Ege, Turkey. Electronic address: ceyla1977@yahoo.com.
FAU - Kisabay, Aysin
AU  - Kisabay A
AD  - Ceyla Atac, Izmir Bozyaka Egitim ve Arastirma Hastanesi, Neurology, 35360 Izmir, 
      Ege, Turkey.
FAU - Cetin Akkoc, Ceren
AU  - Cetin Akkoc C
AD  - Ceyla Atac, Izmir Bozyaka Egitim ve Arastirma Hastanesi, Neurology, 35360 Izmir, 
      Ege, Turkey.
FAU - Saruhan, Gulsum
AU  - Saruhan G
AD  - Ceyla Atac, Izmir Bozyaka Egitim ve Arastirma Hastanesi, Neurology, 35360 Izmir, 
      Ege, Turkey.
FAU - Celebisoy, Nese
AU  - Celebisoy N
AD  - Ceyla Atac, Izmir Bozyaka Egitim ve Arastirma Hastanesi, Neurology, 35360 Izmir, 
      Ege, Turkey.
LA  - eng
PT  - Case Reports
PT  - Journal Article
PT  - Review
PT  - Video-Audio Media
DEP - 20200607
PL  - United States
TA  - J Stroke Cerebrovasc Dis
JT  - Journal of stroke and cerebrovascular diseases : the official journal of National 
      Stroke Association
JID - 9111633
RN  - 0 (Platelet Aggregation Inhibitors)
SB  - IM
MH  - Aged
MH  - Brain Stem Infarctions/*diagnostic imaging/drug therapy/physiopathology
MH  - Diagnosis, Differential
MH  - *Diffusion Magnetic Resonance Imaging
MH  - Head Impulse Test
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Nystagmus, Pathologic
MH  - Platelet Aggregation Inhibitors/therapeutic use
MH  - Predictive Value of Tests
MH  - Reaction Time
MH  - Treatment Outcome
MH  - Vestibular Evoked Myogenic Potentials
MH  - Vestibular Nuclei/*diagnostic imaging/physiopathology
OTO - NOTNLM
OT  - Acute vestibular syndrome
OT  - Diffusion-weighted magnetic resonance images
OT  - HINTS battery
OT  - Vestibular nuclear infaction
EDAT- 2020/07/22 06:00
MHDA- 2020/10/31 06:00
CRDT- 2020/07/22 06:00
PHST- 2020/02/24 00:00 [received]
PHST- 2020/04/15 00:00 [revised]
PHST- 2020/05/03 00:00 [accepted]
PHST- 2020/07/22 06:00 [entrez]
PHST- 2020/07/22 06:00 [pubmed]
PHST- 2020/10/31 06:00 [medline]
AID - S1052-3057(20)30343-8 [pii]
AID - 10.1016/j.jstrokecerebrovasdis.2020.104937 [doi]
PST - ppublish
SO  - J Stroke Cerebrovasc Dis. 2020 Aug;29(8):104937. doi: 
      10.1016/j.jstrokecerebrovasdis.2020.104937. Epub 2020 Jun 7.