Isolated transient vertigo: posterior circulation ischemia or benign origin?

Area of Science:

• Neurology
• Vascular Neurology
• Epidemiology

Background:

• Isolated transient vertigo may be the sole symptom of posterior circulation ischemia.
• Differentiating cerebrovascular vertigo from benign causes is crucial due to elevated stroke risk in ischemic cases.
• This study identifies risk factors for cerebrovascular vertigo and future cerebrovascular events.

Purpose of the Study:

• To identify risk factors for cerebrovascular origin of isolated transient vertigo.
• To determine risk factors for future cerebrovascular events in patients with isolated transient vertigo.

Main Methods:

• Retrospective analysis of 339 outpatients with isolated transient vertigo.
• Extracted data included history, clinical findings, diagnosis, and follow-up for stroke or transient ischemic attack (TIA).
• Multivariate regression models (logistic or Cox) and univariate analyses were used to assess risk factors.

Main Results:

• 14.2% of patients were diagnosed with probable or definite cerebrovascular vertigo.
• During follow-up, 7.9% of patients experienced stroke or TIA.
• Presenting with vertigo as the primary complaint, rather than incidentally, was the only consistent risk factor for future stroke or TIA (p=0.028).

Conclusions:

• Follow-up stroke rates in transient isolated vertigo patients are reported for the first time.
• Identifying cerebrovascular origin of transient isolated vertigo remains challenging.
• Presentation mode is the sole consistent risk factor identified, requiring independent prospective validation.