Overview
What is the role of multiple sclerosis in the pathophysiology of central vertigo?
What is the role of acoustic neuromas in the pathophysiology of central vertigo?
What is the pathophysiology of central vertigo?
What is the role of the vertebrobasilar arterial system in the pathophysiology of central vertigo?
What is the role of trauma in the etiology of central vertigo?
What is the prevalence of central vertigo in the US?
What is the mortality and morbidity in central vertigo?
How does the incidence of central vertigo vary by sex?
Which age groups has the highest incidence of central vertigo?
Presentation
Which clinical history findings are characteristic of central vertigo?
How is peripheral vertigo distinguished from central vertigo?
What causes depressed consciousness in patients with central vertigo?
How is nystagmus characterized in patients with central vertigo?
What is the role of the Hallpike (Nylen-Bárány) maneuver in the diagnosis of central vertigo?
What is included in the Drachman dizziness battery for evaluation of central vertigo?
What is the role of the head impulse test in the evaluation of central vertigo?
What does a finding of internuclear ophthalmoplegia suggest in patients with central vertigo?
What does the presence of cranial nerve deficits suggest in patients with central vertigo?
Which neurologic findings are characteristic of central vertigo?
Which cardiac findings are characteristic of with central vertigo?
What are the symptoms of central vertigo due to Ménière disease and acoustic neuroma?
What is the role of positional vertigo in the etiology of central vertigo?
What is the role of cranial nerve deficits in the etiology of central vertigo?
Which symptoms suggest a transient ischemic attack (TIA) etiology of central vertigo?
Which symptoms suggest an acute cerebellar disease etiology of central vertigo?
What is the role of caudal cerebellar infarction to the etiology of central vertigo?
What is the role of cerebrovascular disease in the etiology of central vertigo?
What are risk factors for central vertigo?
Which symptoms suggest a multiple sclerosis etiology of central vertigo?
DDX
What are the differential diagnoses for Central Vertigo?
Workup
What is the role of lab studies in the workup of central vertigo?
What is the role of imaging studies in the workup of central vertigo?
Which cardiac tests are performed in the workup of central vertigo?
Which neurologic tests are performed in the workup of central vertigo?
Treatment
What is the initial emergency department care of central vertigo?
What is the role of thrombolytic therapy in patients with central vertigo?
What is the role of recombinant activated factor VII for the treatment of central vertigo?
Which specialists should be consulted in the treatment of central vertigo?
Medications
How is increased intracranial pressure (ICP) treated in patients with central vertigo?
Which medications in the drug class Corticosteroids are used in the treatment of Central Vertigo?
Which medications in the drug class Diuretics are used in the treatment of Central Vertigo?
Which medications in the drug class Benzodiazepines are used in the treatment of Central Vertigo?
Follow-up
When is inpatient care indicted for central vertigo?
When is transfer indicated in the treatment of central vertigo?
How is central vertigo prevented in patients with transient ischemic attacks (TIAs)?
What is the prognosis of central vertigo?
What is included in patient education about central vertigo?
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CT scan of a patient with an acute spontaneous cerebellar hemorrhage. The hemorrhage in the right lobe of the cerebellum is partly obscured by bony artifact.
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MRI of a patient with an acute cerebellar hemorrhage less than 24 hours after presentation. MRI allows better resolution than CT scan without bony artifact. MRI is preferred over CT scan for imaging lesions in the posterior fossa.
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CT scan of a patient with a large acoustic neuroma on the right side of the brainstem. The scan was performed after injection of intravenous contrast, which is critical for identifying tumors with CT imaging.
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A CT slice through the brain of a patient with an acoustic neuroma. This slice reveals a level of the brain higher than the acoustic neuroma. The dilated third and lateral ventricles provide gross evidence of obstructive hydrocephalus due to pressure exerted by the tumor on the brainstem. A ventriculostomy, seen as a white circle in the right lateral ventricle, has been placed in an attempt to drain cerebrospinal fluid and relieve the excessive pressure above the brainstem.
