Tan F, et al. - This study incorporated an inquiry of the aetiology and the significance of MRI investigation on the posterior semicircular canal benign paroxysmal positional vertigo, in an Irish cohort. Arriving at its diagnosis appeared to be considerably easy, and the treatment was highly effective. The recommendation put forth was that clinicians ought to be fully aware of and be prepared for the diverse aetiology, thereby not hesitating in requesting for an MRI scan as a vital investigation.

Methods

• The scheme of this trial was a retrospective observational study.
• It recruited 500 patients with posterior semicircular canal benign paroxysmal positional vertigo, diagnosed and treated by the senior author over a 10-year period.
• An MRI brain and inner ear were carried out in maximum patients, following the same scan protocol.
• It encompassed T1 weighted sagittal IR-FSPGR volume, axial T2 weighted, gradient echo T2 weighted and FLAIR sequences plus time of flight cerebral angiography.

Results

• The average age of presentation was 56 years, with the overall female to male ratio was 1.6:1, which was largely the net results of 2 age groups.
• 30% of the enrollees recalled distinct aetiological triggers, of which the top 3 were trauma, infection, and surgery.
• These accounted for 16%, 6%, and 5%, respectively. More than 25% of the patients presented with abnormal intracranial findings on MRI.
• The 2 most common non-infarct incidental findings were neoplasia and vascular abnormalities.
• Fewer than 20 patients had acute intracranial haemorrhage or malignant tumours.
• Yet, most of them were referred to the neurosurgeon on an emergency basis, owing to the life-threatening nature of the condition.
• One round of particle repositioning manoeuver successfully treated 84% of the patients, and the 2-year recurrence rate was only 2.2%.