Relationship between benign paroxysmal positional vertigo and intracranial or extracranial vascular lesions in the elderly / 中华老年医学杂志

ABSTRACT

Objective To explore the relationship between vascular lesions and benign paroxysmal positional vertigo in the elderly.Methods 74 patients aged 60 years and over with benign paroxysmal positional vertigo in Huanhu Hospital and 80 subjects without vertigo history in the medical examination center of the same hospital were randomly divided into the case group and the control group,respectively.The carotid intima-media thickness (CIMT) and plaque in the carotid artery were detected using high-resolution color duplex ultrasound for evaluating large vascular lesions.At the same time,T1WI,T2WI and diffusion weighted imaging (DWI) were performed with high-field 3.0 T MRI scanner as the detection index of small vascular lesions to compare the difference in severity of lacunar infarction,leukoaraiosis and micro hemorrhage between the two groups.Both indexes were used together to compare the overall difference in the intracranial and extracranial vascular lesions between the two groups.Results Between the case group and the control group,there were significant differences in the CIMT [(0.96±0.21) mm vs.(0.84±0.26) mm,t=3.136,P＜0.05],the detection rate of plaque (89.2％ vs.72.5％,x2 =5.803,P＜0.05),the number of lacunar infarction [(3.48± 1.67) vs.(2.34± 2.06),t=1.994,P＜0.05] and the score of white matter [(4.77±2.15) vs.(3.95±2.04),t=2.430,P＜0.05].There was no significant difference in the positive detection rate of the cerebral microbleeds in the case group and control group (22.9％ vs.17.5％,x2=0.4264,P＞0.05).Conclusions There is a relationship between the benign paroxysmal positional vertigo and intracranial or extracranial vascular lesions in the elderly.Vascular factor may play an important role in the pathogenesis of benign paroxysmal positional vertigo.Not only the atherosclerosis of large and small arteries but also the microcirculation disturbance may be partly attributed to the benign paroxysmal positional vertigo in the elderly.