title: Characteristics of central lesions in patients with dizziness determined by diffusion MRI in the emergency department.
abstract: BACKGROUND
  To describe the rate and risk factors of central lesions among patients with dizziness in the emergency department based on diffusion-weighted MRI, which otologists consulted for evaluation of patients with dizziness need to know.
  
  
  METHODS
  902 Consecutive patients who presented with dizziness symptoms as a chief complaint in the emergency department (ED) of our tertiary referral centre between January 2011 and June 2011 were studied. Central lesions were confirmed by diffusion-weighted MRI. Univariate and multivariate analyses were used for factors predictive of central lesions.
  
  
  RESULTS
  Of 645 patients who underwent MRI, 23 (3.6%) had acute central lesions (22 infarcts/1 haemorrhage). Univariate analyses revealed that older age, hypertension, atrial fibrillation, non-whirling type of dizziness symptoms and combined neurological symptoms were significantly associated with the development of central lesions (p<0.05). The incidence of central lesions in patients aged in their 40s, 50s, 60s, 70s and ≥80s was 0, 3.9%, 3.4%, 7.4% and 16.7%. Multivariate analyses showed that hypertension (p=0.01, OR=3.42), symptoms of non-whirling type (p=0.03, OR=3.12) and combined neurological symptoms (p<0.01, OR=16.72) were independent predictors of central lesions.
  
  
  CONCLUSIONS
  Although dizziness in the ED is generally benign, the prevalence of acute central lesions was 3.6% among 645 patients with dizziness who underwent MRI. Old age (>50 years), hypertension, non-whirling type of dizziness symptoms and associated neurological symptoms were significant risk factors for central lesions.
authors.affiliation: Department of Otolaryngology, Asan Medical Center, University of Ulsan, Seoul, Republic of Korea Department of Otolaryngology, GuroSungshim Hospital, Seoul, Republic of Korea.
authors.forename: Dong Hwan
authors.initials: DH
authors.lastname: Lee
authors.affiliation: Department of Emergency, Asan Medical Center, University of Ulsan, Seoul, Republic of Korea.
authors.forename: Won Young
authors.initials: WY
authors.lastname: Kim
authors.affiliation: Department of Otolaryngology, Asan Medical Center, University of Ulsan, Seoul, Republic of Korea Department of Otolaryngology, Jeju Seogwipo Medical Center, Jeju, Republic of Korea.
authors.forename: Byoung Soo
authors.initials: BS
authors.lastname: Shim
authors.affiliation: Department of Otolaryngology, Asan Medical Center, University of Ulsan, Seoul, Republic of Korea Department of Otolaryngology, Kangwon National University, Chuncheon, Republic of Korea.
authors.forename: Tae Su
authors.initials: TS
authors.lastname: Kim
authors.affiliation: Department of Otolaryngology, Asan Medical Center, University of Ulsan, Seoul, Republic of Korea.
authors.forename: Joong Ho
authors.initials: JH
authors.lastname: Ahn
authors.affiliation: Department of Otolaryngology, Asan Medical Center, University of Ulsan, Seoul, Republic of Korea.
authors.forename: Jong Woo
authors.initials: JW
authors.lastname: Chung
authors.affiliation: Department of Otolaryngology, Asan Medical Center, University of Ulsan, Seoul, Republic of Korea.
authors.forename: Tae Hyun
authors.initials: TH
authors.lastname: Yoon
authors.affiliation: Department of Otolaryngology, Asan Medical Center, University of Ulsan, Seoul, Republic of Korea.
authors.forename: Hong Ju
authors.initials: HJ
authors.lastname: Park
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D002561:Cerebrovascular Disorders / Q000453:epidemiology* / Q000209:etiology; D038524:Diffusion Magnetic Resonance Imaging; D004244:Dizziness / Q000175:diagnosis* / Q000209:etiology*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors
keywords: imaging, CT/MRI