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Incidence, characteristics, and neuroanatomical substrates of vestibular symptoms in supratentorial stroke

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Author(s)
Ji-Yun ParkJae-Hwan ChoiJee-Hyun KwonYoung Cheol WeonSuk-Min LeeHyo Jung KimSeo Young ChoiEun Hye OhHyun Ah KimHyung LeeJi-Soo KimKwang-Dong Choi
Keimyung Author(s)
Kim, Hyun AhLee, Hyung
Department
Dept. of Neurology (신경과학)
Journal Title
J Neurol
Issued Date
2023
Volume
270
Issue
4
Keyword
Acute vestibular syndromeSupratentorial strokeVestibular cortexVestibular hemispheric dominance
Abstract
The incidence and characteristics of acute vestibular symptoms, responsible structures, and lateralization of the causative lesions in supratentorial stroke remain unknown. This study aimed to determine the incidence, clinical features, and anatomical correlation of acute vestibular symptoms in supratentorial stroke. We performed a prospective, multicenter, observational study that had recruited patients with supratentorial stroke from the neurology clinics of referral-based four university hospitals in Korea. All patients received a constructed neuro-otological evaluations, and neuroimaging. We analyzed the incidence of acute vestibular symptoms, abnormal ocular motor and vestibular function tests, and stroke lesions. Of 1301 patients with supratentorial stroke, 48 (3.7%) presented with acute vestibular symptoms, and 13 of them (1%) had the vestibular symptoms in isolation. In patients with acute vestibular symptoms, abnormal findings included spontaneous nystagmus (5%), impaired horizontal smooth pursuit (41%), and abnormal tilt of the subjective visual vertical (SVV) (20%). Video head impulse and caloric tests were normal in all the patients. There was no clear correlation between acute vestibular symptoms and involvement of specific vestibular cortex. In patients with unilateral stroke, there was also no lateralization of the causative lesions of acute vestibular symptoms (left vs. right; 52 vs. 48%), even in patients with vertigo (left vs. right; 58 vs. 42%). This study demonstrates that the incidence of acute vestibular symptoms in supratentorial stroke is 3.7%, with being isolated in 1%. The widespread lesions responsible for acute vestibular symptoms implicate diffuse multisensory cortical-subcortical networks in the cerebral hemispheres without a lateralization.
Keimyung Author(s)(Kor)
김현아
이형
Publisher
School of Medicine (의과대학)
Type
Article
ISSN
1432-1459
Source
https://link.springer.com/article/10.1007/s00415-023-11566-9
DOI
10.1007/s00415-023-11566-9
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/44858
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Neurology (신경과학)
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