warfarin and Vertigo

The antiphospholipid syndrome is the association between the presence of antiphospholipid antibodies, thrombosis and/or pregnancy morbidity and mortality. This report presents two cases of antiphospholipid antibodies and sensorineural hearing loss and discusses the probable causative link. We recommend that patients presenting with sudden sensorineural hearing loss are investigated for evidence of antiphospholipid antibodies. Life long anticoagulation is necessary to prevent life threatening thrombotic or thromboembolic events.

Topics: Anticoagulants; Antiphospholipid Syndrome; Dizziness; Hearing Loss, Sensorineural; Hearing Loss, Sudden; Hearing Loss, Unilateral; Humans; Lupus Coagulation Inhibitor; Male; Middle Aged; Thrombophilia; Thrombosis; Vertigo; Warfarin

A 22-year-old-lady presented with multiple occlusions of the branches of the central retinal artery, accompanied by neuro-encephalic disorders and deafness. This triad is known as SICRET Syndrome (Small Infarction of Cochlear, Retinal and Encephalic Tissue). This rare syndrome, as well referred to as Susac syndrome, affects only the women and the three tissues mentioned above: eye, ear, brain. The course was characterised by a series of partially regressive evolutive steps. A remission had been obtained since two years with immuno-supressor and anti-coagulant therapy. The neuro-encephalic and cochlear disorder regressed in contrast to the severe sequel on the right eye.

Topics: Adult; Anticoagulants; Arterioles; Cerebral Infarction; Cochlea; Deafness; Diagnosis, Differential; Drug Therapy, Combination; Female; Headache; Humans; Immunosuppressive Agents; Infarction; Magnetic Resonance Imaging; Organ of Corti; Prednisolone; Retinal Artery Occlusion; Salicylic Acid; Syndrome; Vertigo; Vision Disorders; Warfarin

Topics: Adult; Anti-Inflammatory Agents; Aspirin; Biphenyl Compounds; Blood Coagulation; Blood Urea Nitrogen; Chlorides; Clinical Trials as Topic; Constipation; Diarrhea; Digestive System; Drug Tolerance; Exanthema; Flatulence; Flufenamic Acid; Fluorine; Headache; Heartburn; Humans; Kidney Function Tests; Male; Mefenamic Acid; Methods; Muscle Cramp; Occult Blood; ortho-Aminobenzoates; Placebos; Potassium; Prothrombin; Sleep Initiation and Maintenance Disorders; Sodium; Uric Acid; Vertigo; Vision Disorders; Vomiting; Warfarin

Isolated vertigo is an important symptom of posterior circulation stroke. It has been reported that 11.3% of patients with isolated vertigo have a stroke and that most lesions are located in the cerebellum, particularly in the posterior inferior cerebellar artery. We report the case of a 63-year-old man with multiple atherosclerotic risk factors and atrial fibrillation who showed repeated episodes of isolated vertigo. His repeated vertigo was short-lasting and was often triggered by body position, mimicking benign paroxysmal positional vertigo. Cranial computed tomography on the third hospital day showed left cerebellar infarction within the territory of the posterior inferior cerebellar artery. The vertigo was ameliorated on the fifth hospital day and warfarin was prescribed for secondary prevention. Clinicians should pay special attention to cases in which a patient presents isolated vertigo, even if it shows transient recurrence or is triggered by a positional change, especially in patients with multiple cerebrovascular risk factors.

Topics: Anticoagulants; Brain Infarction; Cerebellar Diseases; Cerebral Angiography; Computed Tomography Angiography; Humans; Male; Middle Aged; Postural Balance; Posture; Recurrence; Secondary Prevention; Treatment Outcome; Vertigo; Warfarin

Previously reported only a few times before, we present a case of extracranial vertebral dissection and spontaneous frontoparietal subarachnoid hemorrhage (SAH) in the puerperium, discussing possible mechanisms and difficulties in management. A 35-year-old woman presented 10 days postcaesarean section with neck pain and vertigo with normal initial investigations. Following recurrent vertigo, headache, and ataxia, imaging revealed a frontoparietal SAH and vertebral artery dissection. The patient was consequently treated with aspirin, and then following a return of symptoms 3 weeks later, warfarin therapy was continued for 6 months. The possible underlying mechanisms for this case are discussed, including reversible cervical vasoconstriction syndrome and posterior reversible encephalopathy syndrome, although neither was identified. The small SAH alongside recurrent posterior circulation symptoms resulted in the initiation of antithrombotic therapy. This report supports studies demonstrating higher incidence of cervicocephalic arterial dissection in the puerperium. Moreover, the heterogeneous presentation and manifestations of such cases require individualized treatment, and warrant studies into underlying mechanisms behind extracranial dissection and nonaneurysmal SAH.

Topics: Adult; Anticoagulants; Aspirin; Female; Humans; Neck Pain; Puerperal Disorders; Subarachnoid Hemorrhage; Treatment Outcome; Vertebral Artery Dissection; Vertigo; Warfarin

Topics: Adenosine Diphosphate; Adult; Anticoagulants; Blood Platelet Disorders; Diagnosis, Differential; Dizziness; Epinephrine; Female; Humans; Platelet Aggregation; Syndrome; Thromboembolism; Vertigo; Vomiting; Warfarin

Topics: Anticoagulants; Blepharoptosis; Carotid Artery, Internal, Dissection; Cluster Headache; Diagnosis, Differential; Edema; Essential Tremor; Humans; Magnetic Resonance Angiography; Male; Middle Aged; Vasodilator Agents; Verapamil; Vertigo; Warfarin

Topics: Adult; Anticoagulants; Ataxia; Cerebellar Diseases; Cerebellum; Female; Humans; Indians, North American; Magnetic Resonance Angiography; Magnetic Resonance Imaging; Manipulation, Spinal; Medicine, Traditional; Recovery of Function; Stroke; Vertebral Artery Dissection; Vertigo; Warfarin

Topics: Adult; Angiography; Ataxia; Carotid Arteries; Female; Humans; Ischemic Attack, Transient; Male; Middle Aged; Subclavian Steal Syndrome; Vascular Diseases; Vertebral Artery; Vertigo; Warfarin