The International Tinnitus Journal

SPECT of Brain and Vertigo - A Case Report

Vertigo has been identified as a complaint associated with the symptom of tinnitus; as well as a specific clinical type of tinnitus i.e., vestibular tinnitus. Classically, the clinical diagnosis of Meniere's Disease includes a quadrad of complaints, highlighted by episodic vertigo, ear blockage, a gradual progressive sensorineural hearing loss, and an associated complaint of a "low frequency tinnitus". Diagnostic and etiologic difficulties for Meniere's Disease have resulted in multiple diagnostic entities, e.g., Meniere's Syndrome, Cochlear Meniere's Disease; Vestibular Meniere's Disease, etc. Single Photon Emission Computed Tomography (SPECT) imaging of brain is a technique which has been reported to improve the diagnostic accuracy of patients with the symptom of tinnitus; and has now been applied for recurrent persistent vertigo. A case report, diagnosed classically as Meniere's Disease, is presented to demonstrate the increased diagnostic accuracy provided by SPECT of brain for the chief complaint of vertigo. SPECT revealed significant perfusion asymmetries in brain. The medical significance of the SPECT findings and its application for both diagnosis and treatment are presented. INTRODUCTION Single Photon Emission Computed Tomography (SPECT) of brain with the radiopharmaceutical technetium 99m Hexamethyl propyleneamine oxine (Tc-99m-HMPAO) is an imaging technique which has been introduced in an attempt to improve the accuracy of the neurotologic diagnosis of a balance disorder by identification of abnormalities of regional cerebral blood flow (rCSF). A case report is presented of a 48 -year- old -male patient with the chief complaint of vertigo clinically diagnosed to have classical Meniere's Disease to illustrate the increased diagnostic accuracy provided by SPECT of brain. The medical significance of the SPECT findings and its application for both diagnosis and treatment is presented. CASE REPORT A 48 year-old-male physician was seen in neurotologic Reprint requests: