Abstract TP118: Dizziness Rule Out Posterior Circulation Stroke
Objective: Dizziness is the 3rd most common major medical symptom reported and accounts for 3-5% of visits across care settings. In the United States, this translates to 10 million visits per year because of dizziness with roughly 25% of these visits to emergency departments. In this study we tried to evaluate the incidence of posterior circulation strokes in patients presenting to the emergency department with symptoms of isolated dizziness (dizziness, vertigo or imbalance).
Methods: A retrospective review of patients admitted with symptoms of isolated dizziness to the Neurology department at our hospital from May 2010 to May 2012. Inclusion Criteria were all patients had to be seen by a neurologist and have Magnetic Resonance Imaging (MRI). Exclusion Criteria were having long track signs, cranial nerve findings, known metastatic cancer, or history of Menieres disease.
Results: During the study period, among 450 patients 101 patients met the criteria, 60 were admitted for Dizziness, 34 for Vertigo, and 7 for imbalance. Four out of 101 (3.96%) had positive findings on the MRI. Among these 4 patients one was a 28 year old patient who was found to have T2 hyper intensity in the left cerebral peduncle (indicating glioma versus demyelinating disease) which remained stable on repeat scan after a year. Two out of the other 3 patients had acute stroke on Computed Tomography (CT), while the third patient had an age indeterminate lacunar infarct in the brain stem. All 3 patients who had a posterior circulation stroke in our study( 3 out of 101 which is 2.97%) were greater than 45yrs of age and had greater than 2 vascular risk factors for stroke.
Conclusions: Less than 4% (3.96%) of the patients who presented with symptoms of isolated dizziness had posterior circulation strokes or lesions on MRI. The incidence of cerebrovascular events in patients presenting with isolated dizziness without long track signs, cranial nerve findings, or vascular risk factors for stroke is very low.
- © 2012 by American Heart Association, Inc.