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Prevalence of acute dizziness and vertigo in cortical stroke

Chan, YM; Wong, Y; Khalid, N; Wastling, S; Flores-Martin, A; Frank, L-A; Koohi N, N; ... Kaski, D; + view all (2021) Prevalence of acute dizziness and vertigo in cortical stroke. European Journal of Neurology , 28 (9) pp. 3177-3181. 10.1111/ene.14964. Green open access

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Abstract

BACKGROUND: In posterior circulation stroke, vertigo can be a presenting feature. However, whether isolated hemispheric strokes present with vertigo is less clear, despite a few single case-reports in the literature. Here we, a) explored the prevalence of vertigo/dizziness in acute stroke and, b) considered the cortical distribution of these lesions in relation to both the known vestibular cortex and evolution of these symptoms. METHODS: We conducted structured interviews in 173 consecutive unselected patients admitted to the hyperacute stroke unit at the University College London Hospitals. The interview was used to evaluate whether the patient was suffering from dizziness and/or vertigo before the onset of the stroke and at the time of the stroke (acute dizziness/vertigo), and the nature of these symptoms. RESULTS: 112 patients had subcortical lesions and 53 patients had cortical infarcts, of which 21 patients reported acute dizziness. Out of these 21, five patients reported rotational vertigo. 17 of the total 53 patients had lesions in known vestibular cortical areas distributed within the insular and parietal opercular cortices. CONCLUSIONS: The prevalence of vertigo in acute cortical strokes was 9%, with no single locus of lesion overlap. There is growing evidence supporting a lateralised vestibular cortex, with speculation that cortical strokes affecting the right hemisphere, are more likely to cause vestibular symptoms than left-hemispheric strokes. We observed a trend for this association, with the right hemisphere affected in four of five patients who reported spinning vertigo at the onset of the stroke.

Type: Article
Title: Prevalence of acute dizziness and vertigo in cortical stroke
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/ene.14964
Publisher version: https://doi.org/10.1111/ene.14964
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Acute vertigo, cortical, dizziness, stroke, vestibular
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Clinical and Movement Neurosciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Department of Neuromuscular Diseases
URI: https://discovery.ucl.ac.uk/id/eprint/10130106
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