Abstract Details

Title Usefulness 3 tesla magnetic resonance imaging in the evaluation of central acute vestibular syndrome

Topic Neuro-ophthalmology/Neuro-otology

Presentation(s) P15 - Poster Session 15 (5:30 PM-6:30 PM)

Poster/Presentation
Number 2-005

Background Acute vertigo represents one of the most frequent chief complaints in emergency departments. Physical examination and the HINTS acronym have been widely used, considering its elevated specificity and sensitivity during the first 48 hs of symptoms onset for recognising CAVS. Numerous studies have shown HINTS to be superior to magnetic resonance (MRI) in this period of time but most of them with equipment of less than 3 tesla (3T MRI)

Objective To compare results of physical examination using HINTS versus 3T MRI in recognising central acute vestibular syndrome (CAVS)

Design/Methods Retrospective analysis of medical records of patients that were admitted to the ED with acute vertigo between june 2017 and june 2021. We used keywords “vertigo" - “dizziness” - “vestibular syndrome”. Only those that were evaluated by neurology residents and studied with a 3T MRI within the first 48 hours of symptoms onset were considered. Head impulse test (HIT), nystagmus features, skew test and other neurological symptoms at presentation were analyzed.

Results

31 patients met the inclusion criteria, 6 had clinical manifestations compatible with C- AVS. (men=4, median age:57 years). Only 3 referred cardiovascular risk factors (1 smoker/2 dyslipidemia). The reason for consultation was acute vertigo in all patients (2 associating paresthesias and 1 ataxia.). At physical examination 4 presented direction changing nystagmus and none showed an altered HIT. 3T MRI was performed showing diffusion restrictive image/s as a sign of acute ischaemic stroke in all cases (83% in territory dependent of posterior cerebellar artery and 17% in superior cerebellar artery territory)

Conclusions 3TMRI performed during the first 48 hours of symptom onset in patients with clinical findings compatible with CAVS detected an acute lesion in 100% of our patients. Even though our sample size was small, results obtained in 3T MRI are promising and encourage the development of prospective studies for their confirmation.

Authors/Disclosures
Florencia Wainberg, MD (FLENI) PRESENTER	Dr. Wainberg has nothing to disclose.
Alfredo H. Laffue, MD	Dr. Laffue has nothing to disclose.
	No disclosure on file