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Isolated transient vertigo: posterior circulation ischemia or benign origin?

Tobias F Blasberg1, Lea Wolf2, Christian Henke2,3

  • 1Department of Neurology, Frankfurt University Hospital, Schleusenweg 2-16, 60528, Frankfurt am Main, Germany. Tobias.Blasberg@stud.uni-frankfurt.de.

BMC Neurology
|June 16, 2017
PubMed
Summary

Isolated vertigo can signal serious cerebrovascular issues. Patients presenting primarily for vertigo face a higher stroke risk, emphasizing the need for careful evaluation of transient vertigo causes.

Keywords:
CerebrovascularStrokeTransientTransient ischemic attackVertigo

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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.