Prevalence of Stroke and Hypoperfusion in Patients With Isolated Vertigo and Vascular Risk Factors

Zhang, Dao Pei; Li, Hao Ran; Qian, Kun; Yin, Suo; Peng, Yan; Zhang, Huai Liang; Zhao, Min; Zhang, Shu Ling

doi:10.3389/fneur.2018.00974

Cited by 14 publications

(15 citation statements)

References 26 publications

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“…In this chronic process, VAH seemed to be the consequence of the interaction between the unequal VA flow and the basilar artery curvature, or just acted as an initial factor ( 16 ). A hypoplastic VA can also result in the ipsilateral occlusion of this vessel due to a direct decrease in blood flow and easy collapse of the vessel caused by the smaller intracranial VA caliber ( 17 ). A hypoplastic VA can cause ipsilateral posterior inferior cerebellar artery infarction by directly decreasing the blood flow in the smaller intracranial VA ( 18 ).…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Long-Term Death After Medullary Infarction: A Multicenter Follow-Up Study

et al. 2021

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Background and Purpose: We investigated the risk factors for death in patients with medullary infarction (MI) during a long-term follow-up.Methods: We retrospectively examined 179 consecutive patients (130 men and 49 women) who had clinical and MRI findings consistent with MI between February 2012 and January 2017 at three university hospitals. Long-term outcomes were assessed by telephonic interview. The clinical and radiological features and risk factors for poor outcomes (modified Rankin scale score ≥ 3, all-cause death) were analyzed.Results: Mean age of patients was 58.3 ± 12.8 years (range, 25–87); mean follow-up period after stroke onset was 42.7 ± 13.2 months (range, 24–78). Basilar artery (BA) stenosis >50% was more closely related to medial medullary infarction (MMI) than other types. There was greater frequency of ipsilateral vertebral artery hypoplasia (VAH) or V4AH and V4 occlusion in lateral MI than in other types. On rostro-caudal classification, middle (M)+dorsal (D) was most frequent, followed by the ventral (V)+M+D types. 21.2% patients showed poor long-term prognosis. Age ≥ 65 years, recurrent stroke, dysphagia, >50% BA stenosis, and ventral MI were risk factors for poor long-term prognosis. All-cause mortality rate was 10.6%; age ≥ 65 years, recurrent stroke, and dysphagia were risk factors for death in the long-term. Ventral MI and MMI+cerebellar infarction, as well as stroke mechanism of artery-to-artery embolism, were potential risk factors for death in the long-term. Pneumonia and recurrent stroke were major causes of death.Conclusions: Long-term poor outcomes of MI and all-cause mortality were not infrequent. Older age, recurrent stroke, and dysphagia were common risk factors for poor prognosis and death.

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Section: Discussionmentioning

confidence: 99%

Risk Factors for Long-Term Death After Medullary Infarction: A Multicenter Follow-Up Study

et al. 2021

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“…However, the clinical spectrum of cerebellar strokes rarely presents with isolated dizziness or without clear central neurological deficits (e.g., dysarthria or ataxia). Sometimes, isolated acute labyrinthine damage may herald impending pontocerebellar involvement in infarction in the territory of the anterior inferior cerebellar artery and may cause brainstem or cerebellar strokes; vestibular strokes are often overlooked because they mimic more benign hearing disorders [ 24 , 63 ]. Lee et al [ 64 ] and Deng et al [ 65 ] found that vestibular structures were more vulnerable to ischemia than any other structures in the brainstem and cerebellum, with the medial vestibular nucleus being the most vulnerable.…”

Section: Discussionmentioning

confidence: 99%

Vertigo in Acute Stroke Is a Predictor of Brain Location but Is Not Related to Early Outcome: The Experience of Sagrat Cor Hospital of Barcelona Stroke Registry

et al. 2022

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Background: Vertigo is an uncommon symptom among acute stroke victims. Knowledge about the clinical profile, the brain location, and the early outcome in stroke patients with cerebrovascular diseases and vertigo remains limited. Objectives: In this study, the effects of vertigo on cerebral topography and early prognosis in cerebrovascular diseases were investigated. Methods: A comparative analysis in terms of demographics, risk factors, clinical characteristics, stroke subtypes, cerebral and vascular topography, and early outcome was performed between patients with presence or absence of vertigo on a sample of 3743 consecutive acute stroke patients available from a 24-year ongoing single-center hospital-based stroke registry. Results: Vertigo was present in 147 patients (3.9%). Multiple logistic regression analysis showed that variables independently associated with vertigo were: location in the cerebellum (OR 5.59, CI 95% 3.24–9.64), nausea or vomiting (OR 4.48, CI 95% 2.95–6.82), medulla (OR 2.87, CI 95% 1.31–6.30), pons (OR 2.39, CI 95% 1.26–4.51), basilar artery (OR 2.36, CI 95% 1.33–4.17), ataxia (OR 2.33, CI 95% 1.41–3.85), and headache (OR 2.31, CI 95% 1.53–3.49). Conclusion: The study confirmed that the presence of vertigo was not related with increased in-hospital mortality or poor prognosis at hospital discharge. Vertigo is mainly related to non-lacunar vertebrobasilar stroke with topographic localization in the cerebellum and/or brainstem.

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“…The diagnosis of extracranial arterial stenosis was defined as artery stenosis >50% ( 13 ). Smoker was defined as continuous or cumulative history of smoking >9 months and ≥1 cigarette per day ( 14 ). Alcohol consumption during the past 3 months was also recorded (the standard alcohol consumption criteria is equivalent to 300 ml of beer or 100 ml of wine).…”

Section: Methodsmentioning

confidence: 99%

New Insights Into Vertigo Attack Frequency as a Predictor of Ischemic Stroke

et al. 2020

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Background: Recurrent attacks of vertigo account for 2.6 million emergency department visits per year in the USA, of which more than 4% are attributable to ischemic infarction. However, few studies have investigated the frequency of attacks of vertigo before an ischemic stroke.Methods: We conducted this retrospective analysis and manually screened the medical records of 231 patients who experienced recurrent attacks of vertigo prior to an ischemic stroke. Patients were divided into four different groups based on the frequency of vertigo attacks as well as the region of ischemic infarction. Those with ≤2 attacks of vertigo preceding the ischemic stroke were defined as the low-frequency group. Those with ≥3 attacks were defined as the high-frequency group. Clinical parameters, including vascular risk factors, average National Institutes of Health Stroke Scale (NIHSS) score, and infarction volume, were compared between the groups.Results: On analysis, we found that patients with posterior infarction in the high-frequency group exhibited a higher prevalence of vertebral artery stenosis. However, the incidence of diabetes mellitus (DM) was higher in the low-frequency group. In addition, patients with posterior infarction in the low-frequency group were more active in seeking medical intervention after an attack of vertigo. Notably, the brain stem, especially the lateral medullary region, had a higher probability of being involved in posterior infarction in the high-frequency group. However, the cerebellum was more commonly involved in posterior infarction in the low-frequency group.Conclusions: Our findings indicate that the clinical parameters, including arterial stenosis, DM, and magnetic resonance imaging (MRI) findings, differed between the low- and high-frequency groups. We also found that patients in the low-frequency group were more willing to seek medical intervention after the attacks of vertigo. These findings could be valuable for clinicians to focus on specific examination of the patients according to the frequency of vertigo attacks.

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Prevalence of Stroke and Hypoperfusion in Patients With Isolated Vertigo and Vascular Risk Factors

Cited by 14 publications

References 26 publications

Risk Factors for Long-Term Death After Medullary Infarction: A Multicenter Follow-Up Study

Risk Factors for Long-Term Death After Medullary Infarction: A Multicenter Follow-Up Study

Vertigo in Acute Stroke Is a Predictor of Brain Location but Is Not Related to Early Outcome: The Experience of Sagrat Cor Hospital of Barcelona Stroke Registry

New Insights Into Vertigo Attack Frequency as a Predictor of Ischemic Stroke

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