Vascular vertigo and dizziness: Diagnostic criteria

Area of Science:

• Neurology
• Otolaryngology
• Vascular Medicine

Background:

• Vertigo and dizziness are common symptoms, often linked to posterior circulation strokes.
• Accurate diagnosis of vascular vertigo is crucial for effective treatment and stroke prevention.

Purpose of the Study:

• To present the Bárány Society's Committee for the Classification of Vestibular Disorders' diagnostic criteria for vascular vertigo and dizziness.
• To include classifications for stroke, transient ischemic attack, labyrinthine infarction/hemorrhage, and vertebral artery compression syndrome.

Main Methods:

• The paper outlines diagnostic criteria developed by an expert committee.
• It emphasizes the role of central neurological signs, including HINTS (Head-Impulse test, Nystagmus, Skew deviation), in diagnosing vascular vertigo.
• Diagnostic considerations for isolated labyrinthine infarction and vertebral artery compression syndrome are detailed.

Main Results:

• The classification encompasses vertigo/dizziness from stroke, transient ischemic attack, labyrinthine infarction/hemorrhage, and vertebral artery compression syndrome.
• Vascular vertigo can be acute and prolonged or transient.
• Central HINTS signs in patients with acute vestibular symptoms and vascular risk factors strongly suggest vascular vertigo.

Conclusions:

• The presented criteria provide a framework for diagnosing vascular vertigo and dizziness.
• Early consideration of vascular causes, especially with central neurological signs and risk factors, is vital.
• Specific diagnostic pathways are outlined for labyrinthine infarction and vertebral artery compression syndrome.