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Does intracerebral haemorrhage mimic benign dizziness presentations? A population based study
Kevin A Kerber1, James F Burke, Devin L Brown
1Department of Neurology, University of Michigan Health Systems, Ann Arbor, MI 48109, USA. kakerber@umich.edu
Emergency Medicine Journal : EMJ
|January 20, 2011
Summary
Intracerebral hemorrhage (ICH) rarely presents as isolated dizziness. Head CT scans for dizziness may not be necessary to rule out ICH, as it typically causes other neurological symptoms.
Area of Science:
- Neurology
- Radiology
- Emergency Medicine
Background:
- Head CT scans are often used to rule out stroke in patients presenting with dizziness.
- CT imaging has limitations in detecting acute ischemic stroke, particularly in the posterior fossa.
- Intracerebral hemorrhage (ICH) is the primary stroke type adequately evaluated by CT.
Purpose of the Study:
- To determine the frequency of intracerebral hemorrhage (ICH) mimicking a benign dizziness presentation.
- To assess the utility of head CT scans in evaluating dizziness when stroke is suspected.
Main Methods:
- Utilized a population-based stroke database (Brain Attack Surveillance in Corpus Christi) from 2000-2007.
- Reviewed hospital records of 595 ICH cases.
- Classified cases with isolated dizziness and a National Institutes of Health Stroke Scale score <2 as potential benign dizziness presentations.
Main Results:
- Only 2.2% of ICH cases presented with dizziness as the primary symptom and a low NIH Stroke Scale score.
- No ICH cases perfectly mimicked a benign dizziness presentation.
- Most ICH cases exhibited focal or global neurological deficits or examination abnormalities.
Conclusions:
- Intracerebral hemorrhage is unlikely to present as a benign dizziness episode.
- Screening for ICH in patients with benign-appearing dizziness may not be essential, considering CT limitations.
- Further research is recommended to confirm these findings and refine diagnostic strategies.
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