title: How Commonly Is Stroke Found in Patients with Isolated Vertigo or Dizziness Attack?
abstract: BACKGROUND
  The sudden development of vertigo or dizziness without focal neurological symptoms is generally attributable to vestibular diseases such as benign paroxysmal positional vertigo. Isolated vertigo or dizziness attack needs more attention than vestibular diseases. This retrospective study was performed to elucidate the frequency of strokes in patients with isolated vertigo or dizziness attack.
  
  
  METHODS
  We enrolled 221 patients (men, 119; women, 102; mean age, 68.4 ± 10.3 years) who were admitted to our hospital over the last 10 years because of sudden isolated vertigo or dizziness attack without other neurological symptoms except for nystagmus, deafness, or tinnitus. We investigated the clinical features, final diagnosis, neuroimaging findings, and short- or long-term outcome of these patients.
  
  
  RESULTS
  One hundred eighteen patients had vertigo whereas the other 103 had dizziness. Brain computed tomography or magnetic resonance imaging revealed recent stroke lesions in 25 patients (11.3%) (ischemic, 21; hemorrhagic, 4).The lesions were generally small and localized in the cerebellum (n = 21), pons (n = 1), medulla oblongata (n = 1), or corona radiata (n = 1). Of the 25 patients, 19 (76%) had dizzy-type spells; none had neurological dysfunction at the time of discharge. In the remaining 196 patients, no stroke was detected on computed tomography or magnetic resonance imaging.
  
  
  CONCLUSIONS
  Stroke was found in 11% of patients with isolated vertigo or dizziness attack. The posterior inferior cerebellar artery area was the most frequently implicated for isolated vertigo or dizziness.
authors: Division of Neurology, Department of Stroke and Cerebrovascular Diseases, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan; Department of Neurology, Iwate Prefectural Central Hospital, Morioka, Iwate, Japan. Electronic address: doijirir@gmail.com.
authors: Ryosuke
authors: R
authors: Doijiri
authors: Division of Neurology, Department of Stroke and Cerebrovascular Diseases, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
authors: Hisakazu
authors: H
authors: Uno
authors: Division of Neurology, Department of Stroke and Cerebrovascular Diseases, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
authors: Kotaro
authors: K
authors: Miyashita
authors: Division of Neurology, Department of Stroke and Cerebrovascular Diseases, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
authors: Masafumi
authors: M
authors: Ihara
authors: Division of Neurology, Department of Stroke and Cerebrovascular Diseases, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
authors: Kazuyuki
authors: K
authors: Nagatsuka
mesh_terms: D000368:Aged; D038524:Diffusion Magnetic Resonance Imaging; D004244:Dizziness / Q000209:etiology*; D005260:Female; D006801:Humans; D007564:Japan; D014854:Lateral Medullary Syndrome / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D013997:Time Factors; D014717:Vertigo / Q000209:etiology*
keywords: Isolated vertigo; isolated dizziness; posterior inferior cerebellar artery; stroke