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Do monosymptomatic stroke patients with dizziness present a vestibular syndrome without nystagmus? An underestimated entity.
Nikles, Florence; Kerkeni, Hassen; Zamaro, Ewa; Korda, Athanasia; Wagner, Franca; Sauter, Thomas C; Kalla, Roger; Morrison, Miranda; Mantokoudis, Georgios.
Afiliação
  • Nikles F; Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, University Hospital Bern and University of Bern, Bern, Switzerland.
  • Kerkeni H; Department of Neurology, Inselspital, University Hospital Bern and University of Bern, Bern, Switzerland.
  • Zamaro E; Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, University Hospital Bern and University of Bern, Bern, Switzerland.
  • Korda A; Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, University Hospital Bern and University of Bern, Bern, Switzerland.
  • Wagner F; University Institute of Diagnostic and Interventional Neuroradiology, Inselspital, University Hospital Bern and University of Bern, Bern, Switzerland.
  • Sauter TC; Department of Emergency Medicine, Inselspital, University Hospital Bern and University of Bern, Bern, Switzerland.
  • Kalla R; Department of Neurology, Inselspital, University Hospital Bern and University of Bern, Bern, Switzerland.
  • Morrison M; Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, University Hospital Bern and University of Bern, Bern, Switzerland.
  • Mantokoudis G; Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, University Hospital Bern and University of Bern, Bern, Switzerland.
Eur J Neurol ; 31(1): e16066, 2024 01.
Article em En | MEDLINE | ID: mdl-37738525
ABSTRACT
BACKGROUND AND

PURPOSE:

Vestibular symptoms are common in emergency department (ED) patients and have various causes, including stroke. Accurate identification of stroke in patients with vestibular symptoms is crucial for timely management. We conducted a prospective cross-sectional study from 2015 to 2019 to determine stroke prevalence and associated symptoms in ED patients with vestibular symptoms, aiming to improve diagnosis and outcomes.

METHODS:

As part of the DETECT project, we screened 1647 ED patients with acute vestibular symptoms. Following a retrospective analysis of 961 head and neck magnetic resonance imaging (MRI) scans, we included 122 confirmed stroke cases and assessed them for vestibular signs and symptoms.

RESULTS:

Stroke prevalence in dizzy patients was 13% (122/961 MRI scans). Most patients (95%) presented with acute vestibular symptoms with or without nystagmus, whereas 5% had episodic vestibular syndrome (EVS). Nystagmus was present in 50% of stroke patients. Eighty percent had a purely posterior circulation stroke, and nystagmus was absent in 46% of these patients. Seven patients (6%) had lesions in both the anterior and posterior circulation. Vertigo was experienced by 52% regardless of territory.

CONCLUSIONS:

A stroke was identified in 13% of ED patients presenting with acute vestibular symptoms. In 5%, it was EVS. Most strokes were in the posterior circulation territory; vertigo occurred with similar frequency in anterior and posterior circulation stroke, and absence of nystagmus was common in both.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Doenças Vestibulares / Nistagmo Patológico / Acidente Vascular Cerebral Tipo de estudo: Observational_studies / Risk_factors_studies Limite: Humans Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Doenças Vestibulares / Nistagmo Patológico / Acidente Vascular Cerebral Tipo de estudo: Observational_studies / Risk_factors_studies Limite: Humans Idioma: En Ano de publicação: 2024 Tipo de documento: Article