| Neuroradiological features of vertigo. | |
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MedLine Citation:
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PMID: 15045615 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The diagnostic pathway in a patient with vertigo starts with the accurate evaluation of medical history followed by a general physical and neurological examination. This step can often lead to the identification of the correct cause of the disease or, at least, to a distinction between peripheral and central vertigo. Neuroradiological investigations have to be considered as elective diagnostic procedures and include: computed tomography (CT), magnetic resonance (MR), MR angiography (MRA), angiography. For the diagnosis of peripheral vertigo, benign paroxysmal positional vertigo, labyrinthitis, Meniere disease, perilymphatic fistula, local trauma, toxic labyrinthitis, acute otitis media and chronic middle ear effusion,the role of imaging techniques is controversial. CT and MR are performed to rule out other pathologies and to confirm the diagnosis. Increased resolution and application of special MR sequences enhancing the intralabyrinthine fluids have enabled more detailed analysis of labyrinthine structures and pathology. Both T2 and T1 contrast sequences are necessary. A high resolution CT study is required when otitis media is suspected and in the follow-up of post-traumatic vertigo. The causes of central vertigo are numerous and include: vertebro-basilar circulation vascular events, multiple sclerosis (MS), migraine-associated vertigo, cerebellar and brainstem tumors, CNS infections. Among them cerebrovascular ischemia and multiple sclerosis are the most frequent. In these situations imaging studies become mandatory. CT can diagnose most cerebellar hemorrhages and some cerebellar and brainstem acute ischemia, enhanced MR has proved to be the most sensitive tool to detect posterior fossa lesion. Diffusion-weighted MR can reveal acute ischemic changes before routine MR. There has been evidence that MR angiography, providing angiogram-like images of the intracranial vessels may sometimes avoid invasive angiography. MRA resolution is not as good as traditional angiography and may also be compromised by movements and other artifacts. Selective angiography of the posterior circulation is often indicated for therapeutic decisions. |
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Authors:
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M G Bruzzone; M Grisoli; T De Simone; C Regna-Gladin |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology Volume: 25 Suppl 1 ISSN: 1590-1874 ISO Abbreviation: Neurol. Sci. Publication Date: 2004 Mar |
Date Detail:
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Created Date: 2004-03-26 Completed Date: 2004-06-10 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 100959175 Medline TA: Neurol Sci Country: Italy |
Other Details:
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Languages: eng Pagination: S20-3 Citation Subset: IM |
Affiliation:
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Neuroradiology Department, Istituto Nazionale Neurologico "C. Besta", Via Celoria 11, Milan, Italy. mariagraziabruzzone@yahoo.it |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Brain
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pathology,
physiopathology,
radiography Humans Magnetic Resonance Angiography / standards Magnetic Resonance Imaging / standards Tomography, X-Ray Computed / standards Vertebrobasilar Insufficiency / pathology, physiopathology, radiography Vertigo / pathology, physiopathology, radiography* Vestibular Diseases / pathology, physiopathology, radiography* Vestibule, Labyrinth / pathology, physiopathology, radiography* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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