Small strokes causing severe vertigo: Frequency of false-negative MRIs and nonlacunar mechanisms

Neurology

Volumn 83, Issue 2, 2014, Pages 169-173

  Tehrani, Ali S Saber ^a   Kattah, Jorge C ^a   Mantokoudis, Georgios ^b   Pula, John H ^a   Nair, Deepak ^a   Blitz, Ari ^b   Ying, Sarah ^b   Hanley, Daniel F ^b   Zee, David S ^b   Newman Toker, David E ^b  

^a UNIVERSITY OF ILLINOIS   (United States)

^b JOHNS HOPKINS UNIVERSITY SCHOOL OF MEDICINE   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ACUTE DISEASE; ACUTE VESTIBULAR SYNDROME; ADULT; AGED; ARTERY DISSECTION; ARTICLE; CEREBROVASCULAR ACCIDENT; CLINICAL ARTICLE; CONTROLLED STUDY; CROSS-SECTIONAL STUDY; DIAGNOSTIC ACCURACY; DIAGNOSTIC TEST ACCURACY STUDY; DIFFUSION WEIGHTED IMAGING; DIZZINESS; FEMALE; GAIT DISORDER; HEAD IMPULSE NYSTAGMUS TEST OF SKEW PLUS HEARING EXAMINATION; HEAD MOVEMENT; HUMAN; INFERIOR CEREBELLAR PEDUNCLE; LABORATORY DIAGNOSIS; MALE; MEDULLA OBLONGATA; MIDDLE AGED; NAUSEA AND VOMITING; NEUROIMAGING; NEUROLOGIC EXAMINATION; NYSTAGMUS; PATIENT REFERRAL; PRIORITY JOURNAL; REPEAT PROCEDURE; RISK FACTOR; SYNDROME; VERTEBRAL ARTERY STENOSIS; VERTIGO; VERY ELDERLY; VESTIBULAR DISORDER; COMPLICATION; IMAGE PROCESSING; LACUNAR STROKE; NUCLEAR MAGNETIC RESONANCE IMAGING; OPTOKINETIC NYSTAGMUS; PATHOLOGY; PHYSIOLOGY; POSTERIOR FOSSA; PROCEDURES; PROSPECTIVE STUDY;

ADULT; AGED; AGED, 80 AND OVER; CRANIAL FOSSA, POSTERIOR; CROSS-SECTIONAL STUDIES; DIFFUSION MAGNETIC RESONANCE IMAGING; FALSE POSITIVE REACTIONS; FEMALE; HUMANS; IMAGE PROCESSING, COMPUTER-ASSISTED; MAGNETIC RESONANCE IMAGING; MALE; MIDDLE AGED; NYSTAGMUS, PHYSIOLOGIC; PROSPECTIVE STUDIES; STROKE; STROKE, LACUNAR; VERTIGO;

EID: 84903995574     PISSN: 00283878     EISSN: 1526632X     Source Type: Journal    
DOI: 10.1212/WNL.0000000000000573     Document Type: Article

References (20)

1. Kattah JC, Talkad AV, Wang DZ, Hsieh YH, Newman-Toker DE. HINTS to diagnose stroke in the acute vestibular syndrome: three-step bedside oculomotor examination more sensitive than early MRI diffusion-weighted imaging. Stroke 2009;40: 3504-3510.
2. Tarnutzer AA, Berkowitz AL, Robinson KA, Hsieh YH, Newman-Toker DE. Does my dizzy patient have a stroke? A systematic review of bedside diagnosis in acute vestibular syndrome. CMAJ 2011;183: E571-E592.
3. Saber Tehrani AS, Coughlan D, Hsieh YH, et al. Rising annual costs of dizziness presentations to US emergency departments. Acad Emerg Med 2013;20: 689-696.
4. Kim AS, Sidney S, Klingman JG, Johnston SC. Practice variation in neuroimaging to evaluate dizziness in the ED. Am J Emerg Med 2012;30: 665-672.
5. Kerber KA, Brown DL, Lisabeth LD, Smith MA, Morgenstern LB. Stroke among patients with dizziness, vertigo, and imbalance in the emergency department: a population-based study. Stroke 2006;37: 2484-2487.
6. Kim HJ, Lee SH, Park JH, Choi JY, Kim JS. Isolated vestibular nuclear infarction: report of two cases and review of the literature. J Neurol 2014;261: 121-129.
7. Kim HA, Lee H. Recent advances in central acute vestibular syndrome of a vascular cause. J Neurol Sci 2012;321: 17-22.
8. Newman-Toker DE, Kattah JC, Alvernia JE, Wang DZ. Normal head impulse test differentiates acute cerebellar strokes from vestibular neuritis. Neurology 2008;70: 2378-2385.
9. Newman-Toker D, Kerber K, Hsieh Y, et al. HINTS outperforms ABCD2 to screen for stroke in acute continuous vertigo and dizziness. Acad Emerg Med 2013;20: 986-996.
10. Herve D, Mangin JF, Molko N, Bousser MG, Chabriat H. Shape and volume of lacunar infarcts: a 3D MRI study in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy. Stroke 2005;36: 2384-2388.
11. Fisher CM. Vertigo in cerebrovascular disease. Arch Otolaryngol 1967;85: 529-534.
12. A classification and outline of cerebrovascular diseases: II. Stroke 1975;6: 564-616.
13. Paul NL, Simoni M, Rothwell PM. Transient isolated brainstem symptoms preceding posterior circulation stroke: a population-based study. Lancet Neurol 2013;12: 65-71.
14. Huh YE, Koo JW, Lee H, Kim JS. Head-shaking aids in the diagnosis of acute audiovestibular loss due to anterior inferior cerebellar artery infarction. Audiol Neurootol 2013;18: 114-124.
15. Chen L, Lee W, Chambers BR, Dewey HM. Diagnostic accuracy of acute vestibular syndrome at the bedside in a stroke unit. J Neurol 2011;258: 855-861.
16. Jackson C, Sudlow C. Comparing risks of death and recurrent vascular events between lacunar and non-lacunar infarction. Brain 2005;128: 2507-2517.
17. Gottesman RF, Sharma P, Robinson KA, et al. Clinical characteristics of symptomatic vertebral artery dissection: a systematic review. Neurologist 2012;18: 245-254.
18. Newman-Toker DE, Moy E, Valente E, Coffey R, Hines A. Missed diagnosis of stroke in the emergency department: a cross-sectional analysis of a large populationbased sample. Diagnosis 2014. Available at: http://www. degruyter.com/view/j/dx.2014.1.issue-2/dx-2013-0038/dx-2013-0038.xml. Accessed May 23, 2014.
19. Savitz SI, Caplan LR, Edlow JA. Pitfalls in the diagnosis of cerebellar infarction. Acad Emerg Med 2007;14: 63-68.
20. Hopf HC. Vertigo and masseter paresis: a new local brainstem syndrome probably of vascular origin. J Neurol 1987; 235: 42-45.