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首页> 外文期刊>The Laryngoscope: A Medical Journal for Clinical and Research Contributions in Otolaryngology, Head and Neck Medicine and Surgery, Facial Plastic and Reconstructive Surgery .. >Vertebrobasilar insufficiency presenting as isolated positional vertigo or dizziness: a double-blind retrospective cohort study.
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Vertebrobasilar insufficiency presenting as isolated positional vertigo or dizziness: a double-blind retrospective cohort study.

机译：椎基底动脉供血不足表现为孤立的位置性眩晕或头晕：一项双盲回顾性队列研究。

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OBJECTIVES/HYPOTHESIS: Vertebral artery (VA) stenosis caused mainly by atherosclerosis accounts for up to 20% of posterior circulation strokes. Isolated positional vertigo or dizziness can be the initial presentation symptom. The objective is to compare the presence of isolated positional vertigo or dizziness in patients with evaluation of VA morphology, thrombotic stroke risk factors, and evolution of symptoms with time. STUDY DESIGN: Double-blind retrospective cohort study. METHODS: Magnetic resonance angiography reports describing the VAs of 258 patients were reviewed, and 133 were questioned and their hospital charts reviewed for positional vertigo or dizziness. Neurotologic examination was performed on 75 patients. Vestibular testing using electronystagmography was performed on 46 patients. The prevalence of thrombotic stroke factors was evaluated in all patients. Groups were compared using chi-square statistical analysis. RESULTS: A total of 72 patients with normal VAs (group A) were compared with a group of 61 patients with stenotic or hypoplastic VAs (group B). When stratifying patients for stroke risk factors, 85.7% of group B patients complaining of isolated positional vertigo on the questionnaire with at least three stroke risk factors had a vertebral artery abnormality (P = .026). A hypothesized mechanism is transient ischemic attack of the semicircular canals or vestibular nucleus during rotation and extension of the neck, which compresses a contralateral stenotic VA in patients with bilateral VA abnormalities. CONCLUSIONS: In patients complaining of isolated positional vertigo or dizziness of unexplained etiology and having at least three thrombotic stroke risk factors, we recommend a vertebrobasilar radiological evaluation for timely treatment accordingly to the results.
机译：目的/假设：主要由动脉粥样硬化引起的椎动脉狭窄占后循环卒中的20％。孤立的位置性眩晕或头晕可能是最初的表现症状。目的是比较VA形态，血栓性中风危险因素和症状随时间的演变，评估患者孤立性眩晕或头晕的存在。研究设计：双盲回顾性队列研究。方法：回顾了描述258例患者VA的磁共振血管造影报告，对133例患者进行了询问，并检查了他们的医院病历表是否存在位置性眩晕或头晕。对75例患者进行了神经病学检查。使用电眼描记法的前庭测试进行了46例患者。在所有患者中评估了血栓性中风因子的患病率。使用卡方统计分析比较各组。结果：总共72例VA正常的患者（A组）与61例狭窄或增生性VA的患者（B组）进行了比较。在对患者进行卒中危险因素分层时，在问卷中抱怨至少有三个卒中危险因素的B组患者中有87％患有椎动脉异常（P = .026）。假设的机制是在颈部旋转和伸展过程中半规管或前庭核的短暂性缺血发作，这会压缩双侧VA异常患者的对侧狭窄VA。结论：对于主诉孤立的位置性眩晕或病因不明的头晕，并且具有至少三个血栓性中风危险因素的患者，我们建议对椎基底动脉进行影像学评估，以便根据结果及时进行治疗。

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