Vestibular function in carotid territory stroke patients

Pires, Anna Paula Batista de Ávila; Fukujima, Márcia Maiumi; Ganança, Fernando Freitas; Aquino, Letícia de Moraes; Ganança, Maurício Malavasi; Caovilla, Heloísa Helena

doi:10.5935/1808-8694.20130005

Cited by 5 publications

(1 citation statement)

References 17 publications

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“…MCA territory infarction can lead to typical vestibular symptoms, such as dizziness, imbalance, and diminished functional independence, and reflect a disturbance of the central vestibular pathways in the brain. [ 9 , 35 – 37 ] In 2013, Pires et al [ 38 ] reported most acute stroke patients (92.5%) had nonrotational dizziness (52.5%), vertigo (22.5%), imbalance (12.5%), and/or vertigo and imbalance (5%). In long-term stroke, most patients (72.5%) had imbalance (65.0%) and/or nonrotational dizziness (7.5%).…”

Section: Discussionmentioning

confidence: 99%

Central vestibular disorder due to ischemic injury on the parieto-insular vestibular cortex in patients with middle cerebral artery territory infarction

2017

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Central vestibular disorder is common after middle cerebral artery (MCA) territory infarction. The MCA supplies blood to the parieto-insular vestibular cortex (PIVC), a core region of central vestibular symptoms. We report on patients that sustained injuries of the core vestibular pathway to the PIVC with central vestibular disorder following MCA territory infarction, demonstrated on diffusion tensor imaging (DTI). Nineteen patients with MCA territory infarction and 12 control subjects were recruited. To reconstruct the core vestibular pathway to the PIVC, we defined seed region of interest (ROI) as vestibular nuclei of pons and target ROI as the PIVC. Fractional anisotropy (FA), mean diffusivity, and tract volume were measured. In the affected hemisphere, FA value of the core vestibular pathway to the PIVC revealed significant difference between all patient groups and the control group (P < .05). In contrast, patients with symptoms of ataxia only revealed significant decrement of tract volume compared with the control group (P < .05). Additionally, subgroup B revealed significant decrement of tract volume compared with that of subgroup A and the control group (P < .05). In the unaffected hemisphere, there was no significant difference in all DTI parameters between all patient groups and the control group (P < .05). Injury to the core vestibular pathway to the PIVC was demonstrated in patients that revealed typical central vestibular disorder following MCA territory infarction. Analysis of the core vestibular pathway to the PIVC using DTI would be beneficial in clinical evaluation and management of patients with MCA territory infarction.

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