Isolated Nodular Ischemic Infarcts: A Central Lesion That Presents as Peripheral Vertigo.

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dc.contributor.authorYeo, Leonard L L
dc.contributor.authorTeoh, Hock L
dc.contributor.authorRathakrishna, Rahul
dc.contributor.authorLim, Gavin H T
dc.contributor.authorTing, Eric
dc.contributor.authorSharma, Vijay K
dc.date.accessioned2016-03-02T03:36:23Z
dc.date.available2016-03-02T03:36:23Z
dc.date.issued2014-01-01
dc.description.abstractAims and Objective: Giddiness is one of the commonest presenting complaints to the emergency physicians. Differentiation between ‘peripheral’ and ‘central’ etiologies is important to avoid unnecessary investigations and avoid missing a potentially serious diagnosis such as an ischemic stroke. Isolated nodular infarction can present with clinical signs that mimic a peripheral vestibular cause. We present the clinical findings in 14 cases of isolated nodular infarction and discuss their differentiating features. Study Design: Retrospective case series. Place and Duration: Tertiary care university hospital in Singapore between January 2007 to September 2012. Methods: We evaluated the clinico-radiological findings of all the patients diagnosed with isolated nodular infarction at our center during the study period. Their clinical presentations were extracted from the case records. We combined our cases to an existing series of 8 patients from Korea to strengthen the findings. Results: Of the 286 acute posterior circulation ischemic stroke patients admitted to our tertiary care center during the study period, 6 (2.1%) were found to have isolated nodular infarction. They typically presented with acute severe giddiness. Nystagmus was seen in all, which was unidirectional and beating towards the side of the lesion with no latency or fatigability. Walking was usually severely impaired due to imbalance and all patients had a negative head impulse test. All patients at our center achieved complete recovery at 3- months. Conclusions: We present the clinical spectrum of isolated nodular infarction. In addition to a high index of suspicion in patients with multiple vascular risk factors, a negative head impulse test despite severe vertigo and imbalance can help in establishing the correct diagnosis.en_US
dc.identifier.citationYeo Leonard L L, Teoh Hock L, Rathakrishnan Rahul, Lim Gavin H T, Ting Eric, Sharma Vijay K. Isolated Nodular Ischemic Infarcts: A Central Lesion That Presents as Peripheral Vertigo. British Journal of Medicine and Medical Research. 2014 Jan; 4(1): 433-440.en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/174921
dc.language.isoenen_US
dc.source.urihttps://sciencedomain.org/abstract/2079en_US
dc.subjectAcute ischemic strokeen_US
dc.subjectcerebellumen_US
dc.subjectnodulusen_US
dc.subjectvestibularen_US
dc.subjectvertigoen_US
dc.titleIsolated Nodular Ischemic Infarcts: A Central Lesion That Presents as Peripheral Vertigo.en_US
dc.typeArticleen_US
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