Transient Vestibular Symptoms Preceding Posterior Circulation Stroke: A Prospective Multicenter Study.

Area of Science:

• Neurology
• Vascular Neurology
• Neurotology

Background:

• Transient vestibular symptoms (TVSs) are crucial for differentiating vertebrobasilar transient ischemic attacks from acute transient vestibular syndrome.
• Understanding TVSs preceding posterior circulation stroke (PCOS) aids in early diagnosis and intervention.

Purpose of the Study:

• To determine the prevalence and characteristics of TVSs occurring in the 3 months prior to PCOS.
• To identify clinical features that may help distinguish TVSs related to PCOS from other causes of dizziness.

Main Methods:

• A prospective, multicenter observational study involving 447 patients diagnosed with PCOS.
• Data collected included the timing, pattern, frequency, duration, and associated neurological symptoms of preceding TVSs.

Main Results:

• 12% of PCOS patients experienced TVSs in the preceding 3 months.
• TVSs were predominantly dizziness/vertigo (96%), often without imbalance (60%), and typically brief (seconds to minutes).
• Associated neurological symptoms were reported in 11% of patients.

Conclusions:

• Preceding TVSs occur in 12% of PCOS cases within 3 months.
• Isolated dizziness of unknown origin should be considered a potential symptom of vertebrobasilar transient ischemic attack, particularly in patients with vascular risk factors.
• The characteristics of isolated vestibular symptoms in vertebrobasilar transient ischemic attacks are highly variable and atypical.