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J Korean Bal Soc > Volume 1(2); 2002 > Article
Journal of the Korean Balance Society 2002;1(2): 245-252.
급성 고립성 현훈에서의 척추기저동맥 병변에 관한 연구: 환자 대조군 연구
배희준, 김병건
을지의과대학 을지병원 신경과
Vertebrobasilar Pathology of Acute Isolated Vertigo: A Case-Control Study
Hee Joon Bae, Byung Kun Kim
Department of Neurology, Eulji College of Medicine, Eulji Hospital, Korea.bhj1406@eulji.or.kr
Background : Till now, several studies advocated the vascular etiology as a cause of acute isolated vertigo without relevant lesions on magnetic resonance imaging (MRI). However, most of them were case series and ,even in a few case-control studies, inclusion criteria were obscure and vascular risk factors were not considered. Objectives:   To investigate the clinical significance of vertebrobasilar artery (VBA) pathology in acute isolated vertigo without relevant lesions on MRI. Methods : 84 patients (26 male, 59 female; 62.5±10.2 years) with acute isolated vertigo who had no lesions on MRI were gathered. Seventy nine controls (30 male, 49 female; 58.4±10.1 years) consisted of subjects with clinically definite BPPV, epilepsy, tension headache, or lacunar infarction. All the subjects underwent MRI and magnetic resonance angiography (MRA). The vascular pathology of VBA and anterior circulation were examined and graded by the findings of MRA. Focal stenosis more than 50%, non- or faint-visualization, or dolichoectasia of VBA were regarded as significant. Risk factors of atherosclerosis were investigated and the severity of small vessel disease on MRI were ranked. Results : Significant vascular pathology of VBA was found more frequently in patients with acute isolated vertigo (32.1%) than in controls (16.5%) (p<0.05). Among the risk factors of atherosclerosis, hypertension was more common in patients (44.0%) than in controls (29.1%) (p<0.05) and the others were not different between two groups. Significant vascular pathology of anterior circulation and SVD were not different, too (P>0.05). Multivariate analysis including all the possible variables investigated confirmed the significant correlation between VBA pathology and acute isolated vertigo in our subjects (p<0.05). Conclusion : This study demonstrates that there is a signficant correlation between VBA pathology and acute isolated vertigo without lesions on MRI. It can support the importance of VBA pathology as a a cause of acute isolated vertigo.
Keywords: isolated vertigo; vertebrobasilar artery; vascular pathology; magnetic resonance angiography
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