To the Editor.Ìý —We were pleasantly surprised to see the article "Vertigo of Vascular Origin: Clinical and Electronystagmographic Features in 84 Cases," by Drs Grad and Baloh,¹ in which the authors review the findings of 84 patients who were referred for consultation because of vertigo. A diagnosis of ischemia in the territory of the vertebrobasilar circulation was made. There was a high incidence of isolated episodes of sudden-onset vertigo, and, in some instances, these attacks preceded other symptoms of vertebrobasilar ischemia by months. Vascular insufficiency as the cause of vertigo has not received appropriate emphasis. One author² in summarizing "peripheral and systemic causes of dizziness" does not mention the internal auditory artery and the possible effects of occlusion of that artery or its branches. Little has been written about the interruption of the vascular supply to the inner ear as a potential cause of vertigo, although in a