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. 2022 Mar 31:13:818533.
doi: 10.3389/fneur.2022.818533. eCollection 2022.

Cerebral Small Vessel Disease in Elderly Patients With Vestibular Neuritis

Fieke K Oussoren  1   2 , Louise N F Poulsen  3 , Joost J Kardux  3 , Tjard R Schermer  1 , Tjasse D Bruintjes  1   2 , Roeland B van Leeuwen  1
Affiliations

Cerebral Small Vessel Disease in Elderly Patients With Vestibular Neuritis

Fieke K Oussoren et al. Front Neurol. .

Abstract

Background: Acute audiovestibular loss is a neurotologic emergency of which the etiology is frequently unknown. In vestibular neuritis a viral genesis is expected, although there is insufficient evidence to support viruses as the only possible etiological factor. In sudden deafness, a vascular etiology has been proposed in elderly patients, since cardiovascular risk factors are more frequently present and a higher risk of developing a stroke was seen compared to the general population. So far, very little research has been carried out on vascular involvement in elderly patients with vestibular neuritis. Cardiovascular risk factors have a positive correlation with cerebral small vessel disease, visible as white matter hyperintensities, brain infarctions, microbleeds and lacunes on MRI. The presence of these characteristics indicate a higher risk of developing a stroke.

Aim: We investigated whether elderly patients with vestibular neuritis have a higher prevalence of vascular lesions on MRI compared to a control cohort.

Materials and methods: Patients of 50-years and older, diagnosed with vestibular neuritis in a multidisciplinary tertiary referral hospital, were retrospectively reviewed and compared to a control cohort. The primary outcome was the difference in cerebral small vessel disease on MRI imaging, which was assessed by the number of white matter hyperintensities using the ordinal Fazekas scale. Secondary outcomes were the presence of brain infarctions on MRI and the difference in cardiovascular risk factors.

Results: Patients with vestibular neuritis (N = 101) had a 1.60 higher odds of receiving a higher Fazekas score than the control cohort (N = 203) (p = 0.048), there was no difference in presence of brain infarctions (p = 1.0). Hyperlipidemia and atrial fibrillation were more common in patients experiencing vestibular neuritis.

Conclusion: We found a positive correlation of white matter hyperintensities and VN which supports the hypothesis of vascular involvement in the pathophysiology of vestibular neuritis in elderly patients. Further prospective research is necessary to confirm this correlation.

Keywords: MRI; stroke; vascular etiology; vestibular neuritis (VN); white matter hyper intensities.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Fazekas scale for MRI imaging. The figure displays hyperintensities in the deep white matter (upper row) and periventricular (lower row).
Figure 2
Figure 2
Fazekas distribution. The distribution of the Fazekas scale score 1 up to 6 over the both cohorts displayed in percentages. VN, vestibular neuritis.
See this image and copyright information in PMC

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