We believe Meniere attacks arise as a chance association of endolymphatic hydrops and
vascular risk factors for intracerebral ischemia. Hydrops acts as a variable Starling resistor
upon the inner ear vasculature that is capable of inducing ischemic attacks only in people
with reduced perfusion pressure in the ear. The unique characteristics of the attacks (loss of
vestibular response and hearing acutely followed by a return to apparent normalcy over
hours) are explained by the differential sensitivity of the inner ear tissues to transient …