Clinical Features Of Posterior Circulatory Ischemic Isolated Vertigo And Screening Value Comparison Of 4 Stroke Risk Score

Objectives 1 Research the clinical characteristics of posterior circulatory ischemic solitary vertigo and non posterior circulation ischemic isolated vertigo.2 To evaluate and compare the value of 4 stroke risk scales for early screening of posterior circulation ischemic solitary vertigo.Methods Patients who had dizziness or vertigo as the main complaint and neurological examination without neurological deficit(solitary vertigo)were enrolled during March2016 to September 2017 in the Affiliated Hospital of North China University of technology.According to diagnostic criteria and exclusion criteria.The 571 patients were selected,aged 28~90 years.Among of the 571 patients,210 are male,361 are female.The results of previous history,current history,examinations and related auxiliary examination were collected.All patients were test with age,blood pressure,clinical feature,duration of sympotoms,diabetes(ABCD~2),Essen stroke risk score(ESRS),Framingham stroke profile(FSP)and Ischemic cardiovascular disease(ICVD)10 year risk assessment method.According to the patients' medical history,physical examination and auxiliary examination results,the patients were divided into 2 groups,the posterior circulation ischemia of isolated vertigo group(Case group)95 cases,non posterior circulation ischemia isolated vertigo grope(control group)476 cases.By comparing the clinical characteristics of 2groups of vertigo,we analyzed the symptoms and characteristics of posterior circulation ischemic solitary vertigo,evaluated and compare the screening value of the 4 scores for posterior circulation deficiency solitary vertigo.Results 1 The peak age of control group was 50~59 years,followed by 60~69 years.The peak age of case group was 60~69 years,followed by 70~79 years.2 Compared case group with control group,the position change aggravates vertigo,Visual rotation,tinnitus/hearing loss,headache,duration of vertigo was statistically significant difference(P<0.05).control group was higher than that in case group in position change induce/aggravate vertigo,Visual rotation,tinnitus/hearing loss,headache.The duration of vertigo in case group was most from a few minutes to a few hours(77.90%).The duration of vertigo in control group was most less than a few minutes(72.69%).3 In case group,the normal ratio of head magnetic resonance imaging(MRI)and magnetic resonance angiography(MRA)were 6.32%and 2.10%respectively,and the control group was 43.28%and 39.08%respectively,the difference was statistically significant(P<0.05).4 There is a difference in gender,smoking,hypertension,diabetes,cardiovascular history,past stroke or TIA history between case group and control group(P<0.05).5 A significant difference was found between case group and control grope on the score of patients scored by ABCD~2,ESSEN,FSP and ICVD(Posterior Circulation Ischemia Vertigo group:3;3;37%;9.7%;non Posterior Circulation Ischemia Vertigo grope:2;1;13%;2.8%(P<0.05).6 The area under the ROC curve of ABCD~2,ESSEN,FSP,and ICVD scale were 0.783,0.773,0.765,0.772,compared with the baseline,the difference was statistically significant(P<0.05).7 The dividing value of ABCD~2,ESSEN,FSP and ICVD for circulation ischemic solitary vertigo were 3 points,3 points,27%,7.3%.The accuracy was 0.718,0.743,0.725,0.774 respectively,and the difference of accuracy was not statistically significant(P>0.05),as the score increased,the risk of PCI increased.8 The ABCD~2 score and ESSEN score were paralleled with a sensitivity of 86.31%and a specificity of 63.02%.Conclusions 1 Compared with the non PCI isolated vertigo,the onset age of PCI induced solitary vertigo was higher,the duration of vertigo most lasted for several minutes to several hours,and the change of body position induced/aggravated vertigo,visual rotation,tinnitus/hearing loss and headache are less than non posterior circulation schemia vertigo.2 The four score of ABCD~2,ESSEN,FSP,and ICVD all has screening value for posterior circulation ischemia vertigo,the dividing value were 3 points,3 points,27%,7.3%respectively,but it is not good for clinical diagnosis.The higher the score is,the greater the possibility of posterior circulation ischaemic solitary vertigo.4 The parallel diagnosis of ABCD~2 and ESSEN score can improve diagnostic sensitivity.when patients with ABCD~2score or ESSEN score has more than 3 points,patients may be the posterior circulation ischemic vertigo.