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Issue: Issue 1 (2014) – Supplement 1


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Usefulness of Doppler ultrasound in ischemic “vertigo plus”

Author(s):
J.M. de Bray, J.O. Fortrat, L. Laccoureye, and C. Verny
Abstract:
Vertigo is an illusion of a moving environment. Ischemic “vertigo plus” has additional focal neurological symptoms which are sometimes discrete. Before an initial Doppler examination it is possible to analyze voice, audition, gait, and wave of the hands during history taking. A patient presenting vertigo plus has to be considered as an emergency case (Stroke Unit). The following pathologies may present with symptoms of “vertigo plus": (1) Latero-medullar infarction: vertigo and a nasal voice; (2) Infarction in the posterior inferior cerebellar artery (PICA) territory—vertigo and severe ataxia and/or clumsiness of one hand; (3) Progressive infarction of the brainstem with fluctuating symptoms as vertigo, diplopia, and transient hemiparesis; (4) Infarction in the distribution of the anterior inferior cerebellar artery (AICA)—vertigo with unilateral hearing problems in 50% of the cases. With condition (1) and (2) Doppler Ultrasound (DUS) is likely to find a distal obstruction of the ipsilateral vertebral artery, with (3) and (4) a basilar artery stenosis or occlusion can be suspected and detected by DUS. In conclusion, DUS is useful in vertigo plus, especially when the hospital does not have immediate access to magnetic resonance with angio. Anyway, DUS can yield additional intracranial and cervical hemodynamic information, even after this technique.

Keywords: Vertigo, Vertebrobasilar stroke, Emergency, Doppler ultrasound, Transcranial Doppler sonography.

International Journal of Clinical Neurosciences and Mental Health 2014; 1(Suppl. 1):S09

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