İzole Vertigo Hastalarında Karotis-Vertebral Arter Doppler Ultrason Sonuçlarının Değerlendirilmesi
Abstract
Objectives: In patients who are admitted to the neurology polyclinics with dizziness, some investigations are usually carried out considering cerebral
vascular diseases. Isolated vertigo may occur due to posterior circulatory infarction and transient ischemic attack of the vertebrobasilar system. In addition, hypoplasia of the vertebral arteries (VAs) can cause vertigo by reducing blood circulation to the cerebellum and cerebral peduncle. Bilateral VA hypoplasia may cause episodic vertigo attacks. The aim of this study was to determine the frequency of significant stenosis, occlusion and hypoplasia in patients with isolated vertigo, who presented to the neurology outpatient clinic with the complaint of dizziness, and to determine whether the dizziness was a sign of stroke.
Materials and Methods: In this study, Doppler ultrasonography (USG) findings and files of isolated vertigo patients who presented to the neurology outpatient clinic with a complaint of dizziness and who had no pathological findings in their neurological examination were retrospectively analyzed.
Results: Carotid-VA Doppler USG results of 121 patients admitted to the neurology outpatient clinic between March 2019 and July 2019 were evaluated. Pathology was found in Doppler USG in 27 of these patients. Only four (3.3%) had VA hypoplasia.
Conclusion: It is important for treatment to distinguish between central and peripheral vestibular diseases. It is possible to diagnose many cases of peripheral vertigo clinically in advanced age patients. However, these patients should be evaluated by keeping vertebrobasilar insufficiency, carotid artery pathologies and posterior fossa ischemia in mind
Keywords
Dizziness, Doppler Ultrasonography, Stroke, Vertebral Artery, Vertigo
Ethical Statement
Etik Kurul Onayı: Çalışma için; Sağlık Bilimleri Üniversitesi, Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi Klinik Araştırmalar Etik Kurulu’ndan onay alınmıştır (2019-74/05).
Hasta Onayı: Bu retrospektif çalışma için çalışmaya dahil edilen tüm katılımcılardan bilgilendirilmiş onam alınmaktadır.
Hakem Değerlendirmesi: Editörler kurulunun dışından olan kişiler tarafından değerlendirilmiştir.
Yazarlık Katkıları
Cerrahi ve Medikal Uygulama: M.P.A., F.Y.C., Konsept: M.P.A., F.Y.C., Dizayn: M.P.A., F.Y.C., Veri Toplama veya İşleme: M.P.A., F.Y.C., Analiz veya Yorumlama: M.P.A., Literatür Arama: M.P.A., F.Y.C., Yazan: M.P.A., F.Y.C.
Çıkar Çatışması: Yazarlar tarafından çıkar çatışması bildirilmemiştir.
Finansal Destek: Yazarlar tarafından finansal destek almadıkları bildirilmiştir.
References
- 1. Karatas M. Central vertigo and dizziness: epidemiology, differential diagnosis, and common causes. Neurologist. 2008;14:355-364.
- 2. Fedorowicz J, Bielińska M, Olszewski J. Posturography studies in patients with central and mixed vertigo Summary. Otolaryngol Pol. 2018;72:19-25.
- 3. Dorobisz K, Dorobisz T, Janczak D, et al. The evaluation of the sense of hearing in patients with carotid artery stenosis within the extracranial segments. Acta Neurol Belg. 2018;119:385-392.
- 4. Zhang DP, Lu GF, Zhang JW, et al. Vertebral Artery Hypoplasia and Posterior Circulation Infarction in Patients with Isolated Vertigo with Stroke Risk Factors. J Stroke Cerebrovasc Dis. 2017;26:295-300.
- 5. Paşaoğlu L. Vertebrobasilar system computed tomographic angiography in central vertigo. Medicine (Baltimore). 2017;96:e6297.
- 6. Newman-Toker DE, Edlow JA. TiTrATE: A Novel, Evidence-Based Approach to Diagnosing Acute Dizziness and Vertigo. Neurol Clin. 2015;33:577-599.
- 7. Saber Tehrani AS, Kattah JC, Kerber KA, et al. Diagnosing Stroke in Acute Dizziness and Vertigo: Pitfalls and Pearls. Stroke. 2018;49:788-795.
- 8. Neuhauser HK. The epidemiology of dizziness and vertigo. Handb Clin Neurol. 2016;137:67-82.
- 9. Zhang DP, Ma QK, Zhang JW, et al. Vertebral artery hypoplasia, posterior circulation infarction and relative hypoperfusion detected by perfusion magnetic resonance imaging semiquantitatively. J Neurol Sci. 2016;368:41-46.
- 10. Thierfelder KM, Baumann AB, Sommer WH, et al. Vertebral artery hypoplasia: frequency and effect on cerebellar blood flow characteristics. Stroke. 2014;45:1363-1368.