MRI Head and Internal Auditory Canal Without IV Contrast There is no relevant literature regarding the use of MRI head and IAC without IV contrast in the evaluation of isolated AVS. MRI Head With IV Contrast There is no relevant literature regarding the use of MRI head with IV contrast in the evaluation of isolated AVS. MRI Head Without and With IV Contrast Imaging evaluation in isolated AVS without features of central vertigo is unnecessary. MRI of the head without and with IV contrast would be the imaging modality of choice to evaluate demyelinating, autoimmune, inflammatory, or metabolic conditions involving the brainstem or cerebellum, which would all be rare causes of isolated AVS [25]. Although brain parenchymal signal alterations would be demonstrable on precontrast imaging, the addition of gadolinium-containing IV contrast allows for the differentiation of acute and chronic demyelinating lesions as well as detection of other acute inflammation. MRI Head Without IV Contrast Imaging evaluation in isolated AVS without features of central vertigo is unnecessary. Because routine MRI of the head is characteristically normal in vestibular neuritis, MRI is not required for diagnosis. Patients with features of central vertigo or high baseline risk for stroke may be candidates for neuroimaging. In patients with isolated dizziness symptoms without associated neurological symptoms, the incidence of acute central lesions was 2.3% on MRI in a single center of 645 patients presented to the emergency department [37]. The presence of white matter abnormalities identified on MRI of the head, however, has been shown to positively correlate with the risk of developing subsequent chronic vestibular insufficiency and so may be prognostically useful especially in the elderly population [38]. Approximately 3% to 4% of patients presenting with isolated dizziness had acute stroke on MRI DWI [39]. MRI also has a better sensitivity than CT for the detection of parenchymal infarcts.
Dizziness and Ataxia. MRI Head and Internal Auditory Canal Without IV Contrast There is no relevant literature regarding the use of MRI head and IAC without IV contrast in the evaluation of isolated AVS. MRI Head With IV Contrast There is no relevant literature regarding the use of MRI head with IV contrast in the evaluation of isolated AVS. MRI Head Without and With IV Contrast Imaging evaluation in isolated AVS without features of central vertigo is unnecessary. MRI of the head without and with IV contrast would be the imaging modality of choice to evaluate demyelinating, autoimmune, inflammatory, or metabolic conditions involving the brainstem or cerebellum, which would all be rare causes of isolated AVS [25]. Although brain parenchymal signal alterations would be demonstrable on precontrast imaging, the addition of gadolinium-containing IV contrast allows for the differentiation of acute and chronic demyelinating lesions as well as detection of other acute inflammation. MRI Head Without IV Contrast Imaging evaluation in isolated AVS without features of central vertigo is unnecessary. Because routine MRI of the head is characteristically normal in vestibular neuritis, MRI is not required for diagnosis. Patients with features of central vertigo or high baseline risk for stroke may be candidates for neuroimaging. In patients with isolated dizziness symptoms without associated neurological symptoms, the incidence of acute central lesions was 2.3% on MRI in a single center of 645 patients presented to the emergency department [37]. The presence of white matter abnormalities identified on MRI of the head, however, has been shown to positively correlate with the risk of developing subsequent chronic vestibular insufficiency and so may be prognostically useful especially in the elderly population [38]. Approximately 3% to 4% of patients presenting with isolated dizziness had acute stroke on MRI DWI [39]. MRI also has a better sensitivity than CT for the detection of parenchymal infarcts.