ASSESSMENT OF FACTORS RELATED TO SECONDARY VERTIGO DUE TO VASCULAR CAUSES VERIFIED WITH BRAIN-MRI (DWI)

Dizziness, vertigo and imbalance are common complains in patients referring to neurological clinics. In this article we are to find the factors related to secondary vertigo due to vascular causes verified with Brain-MRI (DWI). This study was conducted on 119 patients who were categorized into positive and negative groups for acute cerebrovascular causes of vertigo according to the result of their MRI (DWI) imaging. Comparing patients with normal and abnormal MRI, there was no significant difference in sex (p=0.49), age(p=0.08), history of tobacco usage(p=0.20), hyperlipidemia (p=0.46), diabetes mellitus (p=0.77), hypertension(p=0.13), ischemic heart disease (p=0.90), atrial fibrillation (p=0.33) and ischemic strokes (p=0.33). In physical examinations the difference in hearing loss (p=0.28), tinnitus(p=0.22), vomiting(p=0.63), abnormal gait (p=0.28), and positive head thrust test (p=0.37) was not significant in both groups but there was a significant difference in presence of Babinski sign (p=0.03), headaches (p=0.025), cranial nerve abnormalities (p=0.01), change in severity of vertigo with position (p<0.001), nistagmus (p=0.01) and abnormal finger to nose tests (p<0.001) in the groups. The results show that in patients with focal neurological deficits, headache and nistagmus vertigo is more likely due to central nerve system. Increase in vertigo in lying position can be a sign for peripheral causes but if vertigo increases in sitting positions, it is more likely caused by central system.