Post-stroke dizziness in anterior vs. posterior circulation ischemic stroke

Area of Science:

• Neurology
• Vascular Neurology
• Stroke Medicine

Background:

• Dizziness is a frequent symptom in stroke patients.
• The characteristics and causes of dizziness in anterior circulation stroke (ACS) are not well understood.
• This study compares dizziness in ACS with posterior circulation stroke (PCS).

Purpose of the Study:

• To determine the frequency of dizziness in ACS.
• To identify factors associated with dizziness in ACS.
• To compare dizziness frequency and associated factors between ACS and PCS.

Main Methods:

• Prospective enrollment of 169 acute ischemic stroke patients (98 ACS, 71 PCS).
• Assessment of new-onset dizziness within 7 days of stroke onset.
• Collection of clinical variables, depression/anxiety scores, and neuroimaging data; multivariable logistic regression used.

Main Results:

• Dizziness occurred in 45.9% of ACS patients and 60.6% of PCS patients.
• In ACS, cerebral microbleeds were independently associated with dizziness (aOR=3.19 for presence, aOR=2.38 for higher number).
• In PCS, medullary or cerebellar lesions were linked to dizziness (aOR=3.13).

Conclusions:

• Dizziness is common in ACS, with a frequency similar to PCS.
• The association with cerebral microbleeds, not psychological factors, suggests structural/vascular mechanisms in ACS dizziness.
• Dizziness in ACS warrants increased clinical attention due to potential underlying vascular causes.