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J Korean Bal Soc > Volume 5(1); 2006 > Article
Journal of the Korean Balance Society 2006;5(1): 177-184.
혈관성 어지럼의 치료
서울대학교 의과대학 신경과학교실, 분당서울대학교병원 신경과
Treatment of Vascular Vertigo
Ji Soo Kim, M.D.
Departments of Neurology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Neuroscience Center, Seongnam, Korea
Vertigo is a relatively common manifestation of vertebrobasilar insufficiency. Rarely, focal infarction in the flocculus or in the medial posterior inferior cerebellar artery territory gives rise to isolated vertigo. However, in most cases, attributable lesions have not been demonstrated by brain imaging. The syndrome of sudden onset vertigo or hearing loss is commonly ascribed to inner ear vascular disease, yet the pathophysiology of the presumed ischemic damage is poorly understood. The vestibular end organs are supplied by the internal auditory artery (IAA) through the superior and inferior arterial branches. Even brief periods of ischemia can cause inner ear damage because IAA and its subdivisions are end arteries with minimal collaterals from other major arterial branches. The treatment strategy should be directed to prevent stroke and to stop progression even in patients with isolated vertigo and without identified other etiology. Antiplatelet agents are mostly used for secondary prevention of posterior infarction. However, anticoagulation should be considered in patients with embolic infarction or with progression. Surgical decompression is a vital option in patients with cerebellar stroke and brainstem compression. The clinical usefulness of endovascular procedure remains to be elucidated in posterior stroke Key Words : Vascular vertigo, Treatment
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