Measuring vertebral arteries (VAs) using color-coded ultrasonography and cervical vestibular-evoked myogenic potential (cVEMP) can help to clarify the pathophysiology of transient vascular vertigo/dizziness (TVV), according to a study published online Nov. 11 in Acta Oto-Laryngologica.
Takaki Inui, from Osaka Medical and Pharmaceutical University in Japan, and colleagues clarified the pathophysiology of TVV in 10 TVV patients with central nervous system symptoms (TVVw) and 12 TVV patients without central nervous system symptoms (TVVo). Participants underwent duplex color-coded ultrasonographic evaluation of VAs, caloric tests, and cVEMP.
The researchers found that in TVVw versus TVVo, the mean flow velocity (MV) ratio (peak of MV of contralateral VA divided by target VA) was significantly higher. The occurrence of canal paresis did not differ between TVVw and TVVo. In TVVo cases only (six of 12), abnormal asymmetry ratios of cVEMP were observed, revealing a significant difference in the number of cases between TVVw and TVVo.
“Measuring the blood flow velocity and diameter of the VAs using duplex color-coded ultrasonography may help evaluate TVV,” the authors write. “The different results of vestibular examinations are worth discussing, which may indicate a pathological distinction between TVVw and TVVo.”
Takaki Inui et al, Different results of vestibular examinations and blood flow in cases with transient vascular vertigo/dizziness with or without central nervous system symptoms, Acta Oto-Laryngologica (2022). DOI: 10.1080/00016489.2022.2134587
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