Paşaoğlu Lale
Ankara Numune Training and Research Hospital, Altindag, Ankara, Turkey.
Medicine (Baltimore). 2017 Mar;96(12):e6297. doi: 10.1097/MD.0000000000006297.
The incidence of vertigo in the population is 20% to 30% and one-fourth of the cases are related to central causes. The aim of this study was to evaluate computed tomography angiography (CTA) findings of the vertebrobasilar system in central vertigo without stroke.CTA and magnetic resonance images of patients with vertigo were retrospectively evaluated. One hundred twenty-nine patients suspected of having central vertigo according to history, physical examination, and otological and neurological tests without signs of infarction on diffusion-weighted magnetic resonance imaging were included in the study. The control group included 120 patients with similar vascular disease risk factors but without vertigo. Vertebral and basilar artery diameters, hypoplasias, exit-site variations of vertebral artery, vertebrobasilar tortuosity, and stenosis of ≥50% detected on CTA were recorded for all patients. Independent-samples t test was used in variables with normal distribution, and Mann-Whitney U test in non-normal distribution. The difference of categorical variable distribution according to groups was analyzed with χ and/or Fisher exact test.Vertebral artery hypoplasia and ≥50% stenosis were seen more often in the vertigo group (P = 0.000, <0.001). Overall 78 (60.5%) vertigo patients had ≥50% stenosis, 54 (69.2%) had stenosis at V1 segment, 9 (11.5%) at V2 segment, 2 (2.5%) at V3 segment, and 13 (16.6%) at V4 segment. Both vertigo and control groups had similar basilar artery hypoplasia and ≥50% stenosis rates (P = 0.800, >0.05).CTA may be helpful to clarify the association between abnormal CTA findings of vertebral arteries and central vertigo.This article reveals the opportunity to diagnose posterior circulation abnormalities causing central vertigo with a feasible method such as CTA.
人群中眩晕的发生率为20%至30%，其中四分之一的病例与中枢性病因有关。本研究的目的是评估无卒中的中枢性眩晕患者椎基底动脉系统的计算机断层血管造影（CTA）表现。对眩晕患者的CTA和磁共振图像进行回顾性评估。本研究纳入了129例根据病史、体格检查以及耳科和神经科检查怀疑患有中枢性眩晕且在扩散加权磁共振成像上无梗死迹象的患者。对照组包括120例具有相似血管疾病危险因素但无眩晕的患者。记录所有患者在CTA上检测到的椎动脉和基底动脉直径、发育不全、椎动脉出口部位变异、椎基底动脉迂曲以及≥50%的狭窄情况。对正态分布的变量采用独立样本t检验，对非正态分布的变量采用曼-惠特尼U检验。根据组间分析分类变量分布的差异，采用χ²检验和/或费舍尔精确检验。眩晕组椎动脉发育不全和≥50%狭窄的情况更为常见（P = 0.000，<0.001）。总体而言，78例（60.5%）眩晕患者存在≥50%的狭窄，54例（69.2%）在V1段有狭窄，9例（11.5%）在V2段有狭窄，2例（2.5%）在V3段有狭窄，13例（16.6%）在V4段有狭窄。眩晕组和对照组的基底动脉发育不全和≥50%狭窄率相似（P = 0.800，>0.05）。CTA可能有助于阐明椎动脉CTA异常表现与中枢性眩晕之间的关联。本文揭示了通过CTA等可行方法诊断导致中枢性眩晕的后循环异常的机会。
