Conclusion: In the early stage of vertebrobasilar stroke, an accurate diagnosis was difficult in the Emergency Department even though a radiologic study was performed, but various VNG abnormalities and delayed neurologic signs could help to diagnose whether the origin is central or not. PICA posterior inferior cerebellar artery nystagmus, hearing loss. Stroke occurred in the cerebellum (n = 18, 78%), medulla (n = 4, 17%), and pons (n = 1, 4%). In the analysis of VNG, 11 (48%) cases of direction-changing gaze-evoked nystagmus, 7 (30%) cases of fixation failure in the caloric test, 6 (27%) cases of periodic alternating nystagmus, and 4 (17%) cases of atypical head-shaking nystagmus were presented. 102, 103 Most often this disorder is due to ischemia in the distribution of the posterior inferior cerebellar artery (PICA). Of the 23 patients, 17 (74%) showed aggravation of vertigo or delayed neurologic signs during the admission. The cause of this syndrome is usually the occlusion of the posterior inferior cerebellar artery (PICA) at its origin. Probably the most easily recognized central vestibular disorder is that of Wallenberg syndrome, which is caused by infarction of the lateral medulla (which includes the vestibular nuclei). Vestibular nuclei (CN VIII) Nausea/vomiting, vertigo, nystagmus. Nucleus ambiguus (CN IX, X, XI) Dysphagia, hoarseness, decreased gag reflex, hiccups. Results: Of the 468 cases of acute vestibular syndrome, 23 (4.9%) cases of radiologically proven vertebrobasilar stroke were identified. Posterior Inferior Cerebellar Artery (PICA) Also known as Lateral Medullary Syndrome or Wallenberg Syndrome. Various clinical features, including presenting symptoms, delayed neurologic signs, the site of infarction, and videonystagmographic (VNG) findings were analyzed. ![]() A CT scan of the head showed a left-sided. They were referred to the Otolaryngology Department due to the absence of neurologic signs or even of imaging abnormalities after the initial examination at the Emergency Department. Physical examination revealed Horner syndrome, bidirectional nystagmus, left dysdiadochokinesia, and left ataxia. Methods: The patients who presented with isolated acute spontaneous vertigo with spontaneous nystagmus (acute vestibular syndrome) at the Emergency Department were retrospectively analyzed. From caudal to rostral, obstruction of the posterior inferior cerebellar artery (PICA, also the most frequent location for a cerebellar infarct) leads to a headache and less commonly vomiting, vertigo, horizontal ipsilateral nystagmus, and truncal ataxia. Background: We aimed to investigate the clinical courses and common nystagmus of isolated vertigo patients with vertebrobasilar stroke.
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