Kurşun Oğuzhan, Karataş Hülya
Department of Neurology, Neurointensive Care Unit, Ankara City Hospital, The University of Health Sciences, Ankara, Türkiye.
Institute of Neurological Sciences and Psychiatry, Hacettepe University, Ankara, Türkiye.
Noro Psikiyatr Ars. 2025 Jan 10;62(3):256-258. doi: 10.29399/npa.28793. eCollection 2025.
Vertigo, characterized by a sensation of spinning or movement, presents as a common complaint in primary care, emergency departments, neurology, psychiatry, and otolaryngology clinics. Its diverse etiologies, including inner ear disorders and neurological conditions, pose diagnostic challenges. The diagnostic process typically involves a comprehensive neurological examination, but additional tests like vertebral artery Doppler examination may be necessary, particularly when vascular causes are suspected. However, the necessity of this examination remains unclear. In this retrospective study, we aimed to evaluate the necessity of vertebral artery Doppler/USG examination in patients presenting with vertigo.
A cohort of 1021 patients attending a neurology outpatient clinic with complaints of dizziness/vertigo underwent comprehensive evaluation, including vertebral artery ultrasound/Doppler examination.
The study revealed that the majority of patients (about 90%) exhibited no evidence of significant vertebral artery atherosclerosis. However, hemodynamically significant vertebral artery pathology was observed in 5.1% of patients, predominantly among older male individuals with cardiovascular risk factors. Additionally, anatomical variations in vertebral artery anatomy were noted, highlighting the importance of considering vascular factors in vertigo evaluation.
These findings underscore the importance of tailored diagnostic approaches and comprehensive assessment in patients with vertigo, emphasizing the role of vertebral artery Doppler examination, particularly in specific patient subgroups. Over 60-year-old patients with vertigo are likely to have hemodynamically important vertebral artery atherosclerotic lesions and clinicians should keep this information in mind during daily practice. Understanding the necessity of this adjunctive diagnostic tool can aid in timely diagnosis and management, potentially reducing healthcare costs and optimizing patient outcomes. However, this examination may not be necessary in 90% of vertigo patients.
眩晕以旋转或运动感为特征，是基层医疗、急诊科、神经内科、精神科和耳鼻喉科门诊常见的主诉。其病因多样，包括内耳疾病和神经系统疾病，给诊断带来了挑战。诊断过程通常包括全面的神经系统检查，但可能需要额外的检查，如椎动脉多普勒检查，尤其是怀疑有血管病因时。然而，这项检查的必要性仍不明确。在这项回顾性研究中，我们旨在评估椎动脉多普勒/超声检查在眩晕患者中的必要性。
对1021名因头晕/眩晕主诉前往神经内科门诊就诊的患者进行了包括椎动脉超声/多普勒检查在内的全面评估。
研究显示，大多数患者（约90%）没有明显的椎动脉粥样硬化证据。然而，在5.1%的患者中观察到具有血流动力学意义的椎动脉病变，主要是在有心血管危险因素的老年男性个体中。此外，还注意到椎动脉解剖结构的变异，凸显了在眩晕评估中考虑血管因素的重要性。
这些发现强调了针对眩晕患者采取个性化诊断方法和全面评估的重要性，突出了椎动脉多普勒检查的作用，特别是在特定患者亚组中。60岁以上的眩晕患者可能有具有血流动力学意义的椎动脉粥样硬化病变，临床医生在日常实践中应牢记这一信息。了解这种辅助诊断工具的必要性有助于及时诊断和管理，可能降低医疗成本并优化患者预后。然而，90%的眩晕患者可能不需要这项检查。
