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March 1967

Vascular Implications of Vertigo

Author Affiliations

From the Department of Surgery, Northwestern University Medical School, Chicago.

Arch Otolaryngol. 1967;85(3):292-297. doi:10.1001/archotol.1967.00760040294011

DIZZINESS and vertigo as symptoms suggest inner ear disability and in the past have also implied midbrain ischemia. The intermittency of vertiginous episodes has often been blamed on cerebral vasospasm. Only since 1951 has it been fully appreciated that extracranial arterial lesions could cause intracranial cerebrovascular insufficiency, dizziness, and vertigo.1 Now this concept has largely replaced the older explanation of spasm as an important cause of ischemia. The implications of this are of paramount interest today for two reasons. First, the symptoms of cerebrovascular insufficiency are now regarded as warning signs of an impending stroke. And second, the extracranial lesions which cause much intracranial cerebral ischemia are easily accessible to operative correction. Thus, if warning signs are heeded, stroke can be prevented by timely surgery.

Eastcott's et al2 report of carotid reconstruction for intracranial ischemia in 1954 opened the new field of arterial reconstruction of extracranial cerebral

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