Abstract
ObjectiveTo clarify the relationship of clinical factors with isolated vertigo or dizziness of cerebrovascular origin.MethodsClinical data of patients admitted in East Hospital from Jan. 2015 to Apr. 2016, whose complaint were acute vertigo or dizziness were retrospectively collected. All patients arrived at the emergency department within 24 hr of symptom onset, had no acute ischemic lesion first CT and NIHSS score of 0. Patients were divided into cerebral infarction group and noncerebral infarction group according to subsequent cerebral imaging results and clinical and laboratory factors related to cerebral infarction were analyzed.Result51.6% of patients were female (n = 141). 46 patients (16.8%) were diagnosed with acute cerebral infarction. Baseline demographic data of the two groups was not significantly different. Univariate analysis found that history of smoking (p = 0.009), headache (p = 0.028), unsteadiness (p = 0.009), neuron specific enolase (p = 0.001), and vertebral artery abnormalities found on imaging (p = 0.009) were the significant difference between two groups. Increased neuron specific enolase (p = 0.005) and an abnormal vertebral artery (p = 0.044) were significant on multivariate analysis.Conclusions16.8% of acute isolated vertigo or dizziness presentations were diagnosed with acute cerebral infarction. Increased serum neuron specific enolase and vertebral artery abnormalities were the strongest indicators of acute cerebral infarction.
Highlights
Acute onset vertigo or dizziness is a common symptom of posterior circulation ischemia
Patients were divided into a cerebral infarction group and a noninfarction group according to cerebral MRI or repeat cerebral CT findings
2.1.1 | Inclusion criteria (a) Age ≥18 years; (b) Acute onset vertigo or dizziness accompanied by nausea, headache, and unsteadiness; (c) The interval between symptoms onset and first visit of emergency department (ED) was ≤24 hr;(d) The first National Institutes of health Stroke Scale (NIHSS) score was 0 as assessed by a neurologist; (e) The first cerebral CT
Summary
Acute onset vertigo or dizziness is a common symptom of posterior circulation ischemia. When vertigo or dizziness occurs in isolation or is accompanied by nausea and vomiting with a lack of other symptoms or signs of neurological impairment, the presentation is often presumed to be due to a benign peripheral cause, such as vestibular neuronitis (Hotson & Baloh, 1998). Patients may deteriorate resulting in permanent disability or a life-threatening course. If such patients can be accurately diagnosed at an early stage and receive proper treatment, their outcomes may significantly improve. We conducted a single-center retrospective analysis of patients with isolated vertigo or dizziness to determine the factors related to a cerebrovascular etiology
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