Vertigo and hearing loss

Research output: Chapter in Book/Report/Conference proceedingChapter

10 Scopus citations


Symptoms referable to disorders affecting the inner ear and vestibulocochlear nerve (eighth cranial nerve) include dizziness, vertigo, tinnitus, and hearing loss, in various combinations. Similar symptoms may occur with involvement of the central nervous system, principally the brainstem and cerebellum, to which the vestibular and auditory systems are connected. Imaging choices should be tailored to patient symptoms and the clinical context. Computed tomography (CT) should be used primarily to assess bony structures. Magnetic resonance imaging (MRI) should be used primarily to assess soft-tissue structures. Vascular imaging by angiography or venography should be obtained when vascular lesions are suspected. No imaging should be obtained in patients with typical presentations of common peripheral vestibular or auditory disorders. In current clinical practice, neuroimaging is often overused, especially CT in the assessment of acute dizziness and vertigo in the emergency department. Despite low sensitivity for ischemic strokes, CT is often used to rule out neurologic causes. When ischemic stroke is the principal concern in acute vestibular presentations, imaging should almost always be by MRI with diffusion-weighted images, rather than CT. In this chapter, we describe recommended strategies for audiovestibular imaging based on patient symptoms and signs.

Original languageEnglish (US)
Title of host publicationNeuroimaging Part II, 2016
EditorsJoseph C. Masdeu, R. Gilberto Gonzalez
PublisherElsevier B.V.
Number of pages17
ISBN (Print)9780444534866
StatePublished - Dec 1 2016

Publication series

NameHandbook of Clinical Neurology
ISSN (Print)0072-9752
ISSN (Electronic)2212-4152


  • dizziness
  • hearing loss
  • neuroimaging
  • stroke
  • vertigo
  • vestibular diseases

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology


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