Contribution of intracranial vertebral artery asymmetry to vestibular neuropathy. Issue 7 (28th June 2010)

• Record Type: Journal Article
• Authors: Chuang, Y M; Chern, C M; Liao, W H; Hsu, L C; Lien, C F; Lirng, J F; Shiao, A S; Ko, J S C
• Is Part Of: Journal of neurology, neurosurgery and psychiatry. Volume 82:Issue 7(2011)
• Page Start: 823
• Page End: 825
• Publication Date: 2010-06-28
• Subjects: Vertebral artery hypoplasia -- magnetic resonance angiogram -- vestibular neuropathy or neuronitis -- MRA -- neurootology; Neurology -- Periodicals; Nervous system -- Surgery -- Periodicals; Psychiatry -- Periodicals; 616.8
• DOI: 10.1136/jnnp.2009.203323
• Languages: English
• ISSNs: 0022-3050

Abstract

Abstract : Objectives: To test the hypothesis that vertebral artery hypoplasia (VAH) may affect the lateralisation of vestibular neuropathy (VN), probably through haemodynamic effect on the vestibular labyrinth. Methods: 69 patients with unilateral VN were examined with a magnetic resonance angiographic (MRA) and caloric test. 50 healthy subjects served as controls. The diagnosis of intracranial VAH was based on MRA if <0.22 cm in VA diameter and a diameter asymmetry index >40%. The authors then correlated the canal paretic side with the VAH side. Results: MRA study revealed 29 VAH (right/left: 23/6) in VN subjects and six VAH in controls (right/left: 5/1). The RR of VAH in VN subjects compared with controls was elevated (RR=2.2; 95% CI 1.8 to 2.8). There was a high accordance rate between the side of VAH and VN. Among 29 patients with unilateral VAH, 65.5% (N=19) had an ipsilateral VN, in which left VAH showed a higher accordance rate (83.3%) than the right side (60.9%). VN subjects with vascular risk factors also had a higher VAH accordance rate (81%) than those without (25%). Conclusions: VAH may serve as a regional haemodynamic negative contributor and impede blood supply to the ipsilateral vestibular labyrinth, contributing to the development of VN, which could be enhanced by atherosclerotic risk factors and the left-sided location.