Vertigo and vomiting, headache and brain fever, crooked mouth and eyes, numbness and weakness —— how to look at everything like a cerebral infarction? Today we will talk about one of the most common symptoms – the onslaught of vertigo and vomiting is not a cerebrovascular problem? What is vertigo? Some people say that “fainting” is a great deal of vertigo, this kind of statement, not quite accurate, light-headedness and vertigo are two different things. Vertigo is a kind of motion or positional illusion that causes distortion in the cerebral cortex of the relationship between a person and his or her surroundings, resulting in the sensation of spinning, tilting, and undulating (in simple terms, it is a kind of sensation similar to seasickness or even the feeling of riding a roller coaster). Spinning, jumping, I close my eyes ~ And usually the most common in the office is the acute vestibular syndrome with rapid onset and long duration of spontaneous vertigo, accompanied by postural instability (tilting back and forth, left and right), autonomic symptoms (sweating, panic, nausea, etc.), and intolerance of head movement (not daring to move the head), with or without nystagmus. If you feel so dizzy, could there be a “blockage” in the cerebrovascular system? I’m sure there are not a few people who think this way, but it’s not entirely true. According to statistics, the brainstem and cerebellar lesions account for 7-12% of the spectrum of vertigo or dizziness (the proportion, say high is not high, say low can not be ignored), and one of the main representatives of cerebrovascular disease. “Didn’t I say before that there are many manifestations of cerebrovascular disease? For example, hemiplegia (unilateral limb movement disorder), hemiplegia (unilateral limb numbness/hypesthesia), dysarthria (unclear spitting, nasal accent, big tongue), ataxia (no alignment) and so on. Since these typical manifestations of cerebrovascular disease are easy to recognize, I don’t have hemiplegia, so it can’t be cerebrovascular disease?” Of course not, because infarction of the cerebellar brainstem is difficult to recognize because motor and cortical (speech, cognitive, emotional, etc.) symptoms are not as obvious as those of cerebral infarction. Therefore, the concern is not without significance and should not be taken lightly by either doctor or patient. Head CT cannot show cerebellum, brainstem and other parts of the brain very clearly due to the interference of skull artifacts, while head magnetic resonance diffusion-weighted imaging (MRI-DWI) is a powerful tool for early detection of cerebral infarction. In fact, cranial CT is not omnipotent in many cases, especially for patients with dizziness, cranial magnetic resonance imaging has higher resolution and greater clinical diagnostic value. Is dizziness caused by cervical spondylosis? The term “cervical vertigo” is a thing of the past, and even in textbooks it is hard to find. (It can’t be helped, development is an upward spiral, the result of constant denial and self-negation). Therefore, the intervertebral discs are not to be blamed for “vertigo”, which is easily attributed to “cervical spondylosis”. Since cerebral infarction is only a small part of the possible causes of vertigo, what are some of the most common disorders of vertigo? In first place is the vestibular peripheral diseases, accounting for 44-65% of the spectrum of vertigo (look at this proportion, is not much higher than the previous), including benign episodes of positional vertigo (the famous “otolith”), vestibular neuronitis, Meniere’s disease, sudden deafness with vertigo, vestibular paroxysm, and so on. The so-called vestibular organs are receptors in the labyrinth of the inner ear for the state of your own movement and the position of your head in space, and control the body’s sense of balance. That is, when you lie down, even if you do not open your eyes to see, you also know that you are lying down rather than lying down, is the vestibular function to tell you. Some people are also prone to “motion sickness” when riding in a car, which is related to the vestibular function, is not it clear — this type of vertigo has a close relationship with the ear. Otolithiasis (not “earwax”, I emphasize), which accounts for 17-30% of the vertigo spectrum, is closely related to changes in head position and, if diagnosed, can be repositioned with the assistance of an ENT specialist. In addition, in Meniere’s disease, for example, such diseases are often accompanied by ear symptoms such as tinnitus, a feeling of stuffiness in the ear, and hearing loss. This shows its close relationship with the ear. In addition to those common causes, dizziness can also be seen in vascular, inflammatory, tumor and other causes of cerebellar brainstem lesions (this, although rare, but when it happens, the consequences are still very serious), and psychosomatic dizziness (as the name suggests, there is no pathological damage or damage is minimal, combined with psychosomatic factors). There are also systemic diseases associated with dizziness, such as some anemia, hypoglycemia, thyroid dysfunction, severe heart disease, electrolyte disorders, etc. may lead to dizziness, in addition to upright low blood pressure, pharmacogenetic vertigo, visual vertigo.