Influence of VA Hemodynamics on Orthostatic Vertigo

Abstract

Objective: Orthostatic vertigo (OV) is believed to occur because of hypoperfusion of the brain with orthostatic decrease in blood pressure (BP). We investigated the relationship between the orthostatic hypotension (OH) and orthostatic decrease in vertebral artery blood flow velocity (VAFV) in order to determine whether these 2 factors could trigger OV. Method: In 251 subjects, BP and extracranial doppler sonography spectrum of the VA were recorded in the supine and standing positions. Subjects were categorized into the OH and non-OH groups, and the orthostatic decrease in VAFV in patients with and without OV was evaluated in each group. Results: The OH and non-OH group comprised 40 and 211 patients, respectively. The OH group included 29 patients with OV and 11 patients without OV. The non-OH group included 150 patients with OV and 62 patients without OV. In the OH group, the OV patients exhibited a marked orthostatic decrease in VAFV as compared with those without OV. In the non-OH group, the orthostatic decrease in VAFV was significantly greater in OV patients than in those without OV. Conclusion: Our results suggest that decrease in VAFV induced by standing could trigger OV, irrespective of OH status.