İzole Vertigo Hastalarında Karotis-Vertebral Arter Doppler Ultrason Sonuçlarının Değerlendirilmesi

Amaç: Nöroloji polikliniğine baş dönmesi ile gelen hastalarda genellikle beyin damar hastalıkları ön planda düşünülerek bazı tetkikler yapılmaktadır.İzole vertigo posterior dolaşım enfarktüsü ve vertebrobaziler sistemin geçici iskemik atağı nedeniyle ortaya çıkabilir. Bunun yanı sıra, vertebralarterlerin (VA) hipoplazisi, serebellum ve serebral pedinküle olan kan dolaşımını azaltarak vertigoya neden olabilir. İki taraflı VA hipoplazisi epizodikvertigo ataklarına sebep olabilir. Bu çalışmanın amacı, baş dönmesi şikayetiyle nöroloji polikliniğine gelen izole vertigo teşhisi konulan hastalardaanlamlı stenoz, oklüzyon ve hipoplazi sıklığının tespiti ve inme sinyalcisi olup olmadığının araştırılmasıdır.Gereç ve Yöntem: Bu çalışmada, nöroloji polikliniğine baş dönmesi şikayetiyle başvuran, nörolojik muayenesinde patolojik bulgusu olmayan, izolevertigo hastalarının Doppler ultrasonografi (USG) bulguları ve dosyaları retrospektif olarak incelendi.Bulgular: Baş dönmesi ile Mart 2019-Temmuz 2019 tarihleri arasında nöroloji polikliniğine başvuran 121 hastanın karotis-VA Doppler USG sonuçlarıdeğerlendirildi. Bu hastalardan 27 tanesinde Doppler USG’de patoloji bulundu. Sadece dört (%3,3) tanesinde VA hipoplazisi vardı.Sonuç: Santral kaynaklı ya da periferik vestibüler hastalıklar arasında ayrım yapmak tedavi için önemlidir. İleri yaştaki hastalarda, birçok periferikvertigo olgusuna klinik olarak tanı konulması mümkündür. Ancak bu hastalar vertebrobaziler yetmezlik, karotis arter patolojileri ve arka fossaiskemisi akılda tutularak incelenmelidir.

Evaluation of Carotid-Vertebral Artery Doppler Ultrasound Results in Isolated Vertigo Patients

Objectives: In patients who are admitted to the neurology polyclinics with dizziness, some investigations are usually carried out considering cerebral vascular diseases. Isolated vertigo may occur due to posterior circulatory infarction and transient ischemic attack of the vertebrobasilar system. In addition, hypoplasia of the vertebral arteries (VAs) can cause vertigo by reducing blood circulation to the cerebellum and cerebral peduncle. Bilateral VA hypoplasia may cause episodic vertigo attacks. The aim of this study was to determine the frequency of significant stenosis, occlusion and hypoplasia in patients with isolated vertigo, who presented to the neurology outpatient clinic with the complaint of dizziness, and to determine whether the dizziness was a sign of stroke. Materials and Methods: In this study, Doppler ultrasonography (USG) findings and files of isolated vertigo patients who presented to the neurology outpatient clinic with a complaint of dizziness and who had no pathological findings in their neurological examination were retrospectively analyzed. Results: Carotid-VA Doppler USG results of 121 patients admitted to the neurology outpatient clinic between March 2019 and July 2019 were evaluated. Pathology was found in Doppler USG in 27 of these patients. Only four (3.3%) had VA hypoplasia. Conclusion: It is important for treatment to distinguish between central and peripheral vestibular diseases. It is possible to diagnose many cases of peripheral vertigo clinically in advanced age patients. However, these patients should be evaluated by keeping vertebrobasilar insufficiency, carotid artery pathologies and posterior fossa ischemia in mind.

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