Vertigo and hearing loss

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Symptoms referable to disorders affecting the inner ear and vestibulocochlear nerve (eighth cranial nerve) include dizziness, vertigo, tinnitus, and hearing loss, in various combinations. Similar symptoms may occur with involvement of the central nervous system, principally the brainstem and cerebellum, to which the vestibular and auditory systems are connected. Imaging choices should be tailored to patient symptoms and the clinical context. Computed tomography (CT) should be used primarily to assess bony structures. Magnetic resonance imaging (MRI) should be used primarily to assess soft-tissue structures. Vascular imaging by angiography or venography should be obtained when vascular lesions are suspected. No imaging should be obtained in patients with typical presentations of common peripheral vestibular or auditory disorders. In current clinical practice, neuroimaging is often overused, especially CT in the assessment of acute dizziness and vertigo in the emergency department. Despite low sensitivity for ischemic strokes, CT is often used to rule out neurologic causes. When ischemic stroke is the principal concern in acute vestibular presentations, imaging should almost always be by MRI with diffusion-weighted images, rather than CT. In this chapter, we describe recommended strategies for audiovestibular imaging based on patient symptoms and signs.

Original languageEnglish (US)
Title of host publicationNeuroimaging Part II, 2016
PublisherElsevier B.V.
Pages905-921
Number of pages17
Volume136
ISBN (Print)9780444534866
DOIs
StatePublished - Dec 1 2016

Publication series

NameHandbook of Clinical Neurology
Volume136
ISSN (Print)00729752
ISSN (Electronic)22124152

Keywords

  • dizziness
  • hearing loss
  • neuroimaging
  • stroke
  • vertigo
  • vestibular diseases

ASJC Scopus subject areas

  • Medicine(all)
  • Neurology
  • Clinical Neurology

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