Risk factors for imaging abnormalities in patients with dizziness complaints: an algorithm for ordering brain...

Area of Science:

• Neurology
• Radiology
• Diagnostic Imaging

Background:

• Diagnostic head imaging for dizziness yields low detection rates for abnormalities.
• Identifying patients with dizziness who require urgent head imaging is crucial for timely diagnosis and treatment.

Purpose of the Study:

• To investigate risk factors associated with abnormal computed tomography (CT) or magnetic resonance imaging (MRI) findings in patients presenting with dizziness.

Main Methods:

• Retrospective review of 2,342 head CT or MRI scans for dizziness complaints (2019-2020).
• Analysis of demographics, dizziness patterns, symptoms, comorbidities, and medical history.
• Utilized a Chi-square automatic interaction detection model and multivariable analyses to identify risk factors for abnormal imaging.

Main Results:

• Abnormal findings were detected in 4.8% of scans, including acute cerebral infarction, hemorrhage, tumors, and inner ear abnormalities.
• Loss of consciousness and neurological deficits were the strongest predictors of abnormal findings (OR 55.57, p < 0.001).
• Specific symptoms (hearing loss, nausea/vomiting) and comorbidities (malignancy) also distinguished abnormal from normal imaging (AUC 0.729).

Conclusions:

• Specific risk factors, particularly neurological deficits and loss of consciousness, are significant indicators for abnormal head imaging in dizziness patients.
• These findings aid in identifying individuals with dizziness who may have serious underlying conditions requiring further investigation.
• Further research is recommended to validate these predictive factors.