1. Prospective analysis of video head impulse tests in patients with acute posterior circulation stroke
- Author
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Sang Hee Ha, Dong Kyu Lee, Gayoung Park, Bum Joon Kim, Jun Young Chang, Dong-Wha Kang, Sun U. Kwon, Jong S. Kim, Hong Ju Park, and Eun-Jae Lee
- Subjects
corrective saccades ,dorsal brainstem stroke ,posterior circulation stroke ,vestibular neuritis ,vestibulo-ocular reflex ,video head impulse test ,Neurology. Diseases of the nervous system ,RC346-429 - Abstract
BackgroundVideo head impulse tests (vHITs), assessing the vestibulo-ocular reflex (VOR), may be helpful in the differential diagnosis of acute dizziness. We aimed to investigate vHITs in patients with acute posterior circulation stroke (PCS) to examine whether these findings could exhibit significant abnormalities based on lesion locations, and to evaluate diagnostic value of vHIT in differentiating dizziness between PCS and vestibular neuritis (VN).MethodsWe prospectively recruited consecutive 80 patients with acute PCS and analyzed vHIT findings according to the presence of dorsal brainstem stroke (DBS). We also compared vHIT findings between PCS patients with dizziness and a previously studied VN group (n = 29). Receiver operating characteristic (ROC) analysis was performed to assess the performance of VOR gain and its asymmetry in distinguishing dizziness between PCS and VN.ResultsPatients with PCS underwent vHIT within a median of 2 days from stroke onset. Mean horizontal VOR gain was 0.97, and there was no significant difference between PCS patients with DBS (n = 15) and without (n = 65). None exhibited pathologic overt corrective saccades. When comparing the PCS group with dizziness (n = 40) to the VN group (n = 29), patients with VN demonstrated significantly lower mean VOR gains in the ipsilesional horizontal canals (1.00 vs. 0.57, p
- Published
- 2023
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