Department of Neurology, Eginition Hospital, University of Athens, Greece.
J Neurol Sci. 2010 Mar 15;290(1-2):33-6. doi: 10.1016/j.jns.2009.11.015. Epub 2010 Jan 6.
Single cases with hemispheric, cortical or subcortical, ischemic lesions presenting with rotational vertigo (RV), that challenge the notion of infratentorial or peripheral generation of RV have been published, but the incidence of this symptom in a larger series is unknown. The aim of this study was to investigate whether acute hemispheric cerebrovascular lesions cause vertiginous sensations with particular emphasis on RV.
A total of 112 consecutive stroke patients were assessed in a prospective single-center study over a 22-month inclusion period. Rotational or other vertiginous sensations were assessed using a structured 5-item questionnaire and patients with vertigo were further evaluated with Yardley's Vertigo Symptom Scale. All subjects underwent standard clinical neuro-ophthalmological and neuro-otological testing and data were correlated to imaging findings.
RV was absent among our patients. Few subjects reported non-rotational vertiginous sensations with stroke onset. These were mainly right-hemispheric strokes with concomitant subcortical leukoaraiosis.
In this case series we did not find any patients with spinning sensations which is supportive of the dogma that supratenotrial lesions do not cause RV. Certain hemispheric stroke patterns, however, may be related to non-rotational dizziness.
已有文献报道过一些单侧半球、皮质或皮质下缺血性病变导致的旋转性眩晕（RV）的单一病例，这些病例挑战了 RV 起源于颅后窝或周围的观点，但这种症状在更大系列中的发生率尚不清楚。本研究旨在调查急性半球性脑血管病变是否会引起眩晕感，特别强调 RV。
在 22 个月的纳入期内，对 112 例连续的卒中患者进行前瞻性单中心研究。使用结构化的 5 项问卷评估旋转性或其他眩晕感，有眩晕的患者进一步用 Yardley 眩晕症状量表进行评估。所有患者均接受标准的临床神经眼科和神经耳科检查，并将数据与影像学结果相关联。
我们的患者中没有 RV。少数患者在卒中发作时报告有非旋转性眩晕感。这些患者主要为右侧半球卒中，伴有皮质下白质疏松症。
在本病例系列中，我们没有发现任何出现旋转性感觉的患者，这支持了一个观点，即颅上病变不会引起 RV。然而，某些半球性卒中模式可能与非旋转性头晕有关。
