Rotational vertigo in embolic stroke of the vestibular and auditory cortices.
We describe the unique case of a woman with embolic infarction within the right middle cerebral artery territory who had nonepileptic rotational vertigo, nausea, and unsteady gait that gradually resolved within a week. A well-demarcated lesion of the posterior insula (homologous to parieto-insular vestibular cortex in monkeys) was probably the cause. This is supported by a contraversive tilt of perceived vertical and by involvement of the adjacent auditory (Heschl's) cortex. Dipole source analysis of late auditory evoked potentials revealed a decreased amplitude of a dipole source in the right insular cortex, whereas two other dipoles situated in the temporal lobe showed symmetric activity.
Brandt
T
T
Department of Neurology, Klinikum Grosshadern, Ludwig-Maximilians-University of Munich, Germany.
Bötzel
K
K
Yousry
T
T
Dieterich
M
M
Schulze
S
S
D000161:Acoustic Stimulation; D000328:Adult; D001303:Auditory Cortex / Q000473:pathology*; D002544:Cerebral Infarction / Q000175:diagnosis / Q000503:physiopathology*; D005072:Evoked Potentials, Auditory; D005260:Female; D007839:Functional Laterality; D019786:Gadolinium DTPA; D006801:Humans; D002542:Intracranial Embolism and Thrombosis / Q000175:diagnosis / Q000503:physiopathology*; D008279:Magnetic Resonance Imaging; D009942:Organometallic Compounds; D004369:Pentetic Acid / Q000031:analogs & derivatives; D012399:Rotation; D014717:Vertigo / Q000209:etiology*; D014722:Vestibule, Labyrinth / Q000473:pathology*
D009942:Organometallic Compounds; D004369:Pentetic Acid; D019786:Gadolinium DTPA