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10.1212/WNL.0000000000000573 http://scihub22266oqcxt.onion/10.1212/WNL.0000000000000573 C4117176!4117176!24920847     free     free     free Deprecated: Implicit conversion from float 227.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 227.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 227.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 227.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 227.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534       Neurology 2014 ; 83 (2): 169-73 Nephropedia Template TP {{tp|p=24920847|t=2014. Small strokes causing severe vertigo: Frequency of false-negative MRIs and nonlacunar mechanisms |pdf=|usr=}}{{24920847}} gab.com Text Small strokes causing severe vertigo: Frequency of false-negative MRIs and nonlacunar mechanisms JO: Neurology http://www.kidney.de/pget.php?&tw=1&pmid=24920847 #FOAvip Objective:: Describe characteristics of small strokes causing acute vestibular syndrome (AVS). Methods:: Ambispective cross-sectional study of patients with AVS (acute vertigo or dizziness, nystagmus, nausea/vomiting, head-motion intolerance, unsteady gait) with at least one stroke risk factor from 1999 to 2011 at a single stroke referral center. Patients underwent nonquantitative HINTS ?plus? examination (head impulse, nystagmus, test-of-skew plus hearing), neuroimaging to confirm diagnoses (97% by MRI), and repeat MRI in those with initially normal imaging but clinical signs of a central lesion. We identified patients with diffusion-weighted imaging (DWI) strokes ?10 mm in axial diameter. Results:: Of 190 high-risk AVS presentations (105 strokes), we found small strokes in 15 patients (median age 64 years, range 41?85). The most common vestibular structure infarcted was the inferior cerebellar peduncle (73%); the most common stroke location was the lateral medulla (60%). Focal neurologic signs were present in only 27%. The HINTS ?plus? battery identified small strokes with greater sensitivity than early MRI-DWI (100% vs 47%, p < 0.001). False-negative initial MRIs (6?48 hours) were more common with small strokes than large strokes (53% [n = 8/15] vs 7.8% [n = 7/90], p < 0.001). Nonlacunar stroke mechanisms were responsible in 47%, including 6 vertebral artery occlusions or dissections. Conclusions:: Small strokes affecting central vestibular projections can present with isolated AVS. The HINTS ?plus? hearing battery identifies these patients with greater accuracy than early MRI-DWI, which is falsely negative in half, up to 48 hours after onset. We found nonlacunar mechanisms in half, suggesting greater risk than might otherwise be assumed for patients with such small infarctions. Twit Text FOAVip Small strokes causing severe vertigo: Frequency of false-negative MRIs and nonlacunar mechanisms ????Neurology http://www.kidney.de/pget.php?&tw=1&pmid=24920847 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=24920847 #FOAvip English Wikipedia <ref>{{Cite pmid|24920847}}</ref> Small strokes causing severe vertigo: Frequency of false-negative MRIs and nonlacunar mechanisms #MMPMID24920847 Saber Tehrani AS; Kattah JC; Mantokoudis G; Pula JH; Nair D; Blitz A; Ying S; Hanley DF; Zee DS; Newman-Toker DE Neurology 2014[Jul]; 83 (2): 169-73 PMID24920847show ga Objective:: Describe characteristics of small strokes causing acute vestibular syndrome (AVS). Methods:: Ambispective cross-sectional study of patients with AVS (acute vertigo or dizziness, nystagmus, nausea/vomiting, head-motion intolerance, unsteady gait) with at least one stroke risk factor from 1999 to 2011 at a single stroke referral center. Patients underwent nonquantitative HINTS ?plus? examination (head impulse, nystagmus, test-of-skew plus hearing), neuroimaging to confirm diagnoses (97% by MRI), and repeat MRI in those with initially normal imaging but clinical signs of a central lesion. We identified patients with diffusion-weighted imaging (DWI) strokes ?10 mm in axial diameter. Results:: Of 190 high-risk AVS presentations (105 strokes), we found small strokes in 15 patients (median age 64 years, range 41?85). The most common vestibular structure infarcted was the inferior cerebellar peduncle (73%); the most common stroke location was the lateral medulla (60%). Focal neurologic signs were present in only 27%. The HINTS ?plus? battery identified small strokes with greater sensitivity than early MRI-DWI (100% vs 47%, p < 0.001). False-negative initial MRIs (6?48 hours) were more common with small strokes than large strokes (53% [n = 8/15] vs 7.8% [n = 7/90], p < 0.001). Nonlacunar stroke mechanisms were responsible in 47%, including 6 vertebral artery occlusions or dissections. Conclusions:: Small strokes affecting central vestibular projections can present with isolated AVS. The HINTS ?plus? hearing battery identifies these patients with greater accuracy than early MRI-DWI, which is falsely negative in half, up to 48 hours after onset. We found nonlacunar mechanisms in half, suggesting greater risk than might otherwise be assumed for patients with such small infarctions. äSmall strokes causing severe vertigo: Frequency of false-negative MRIs(epmc).pdf DeepDyve Pubget Overpricing