| Objective:Transcranial Doppler and carotid ultrasound were used to study the changes in cerebral blood flow velocity and cerebrovascular abnormalities in patients with vertigo or dizziness,and to provide a reference for the correct diagnosis and treatment of the disease.Methods:From January 2019 to September 2019,454 cases who visited Neurology Department of the First Hospital of Jilin University because of the main complaint of "vertigo" or "dizziness" were collected,including 219 cases of vertigo and 235 cases of dizziness.The data were retrospectively analyzed,and the characteristics of baseline data and the diagnostic value of TCD and CA in patients with vertigo or dizziness were analyzed.Results:(1)Among the 454 cases with vertigo or dizziness,311 cases(68.5%)were male and 143 cases(31.5%)were female.There was no difference in gender distribution between cases with vertigo and cases with dizziness(c2=1.462,P=0.227>0.05).(2)The maximum age is 89 years old,the minimum age is 25 years old,and the average age is 59.14 years old.23 cases(5.0%)were younger than 40 years old,216 cases(47.6%)were between 40 and 60 years old,and 215 cases(47.4%)were older than 60 years old.There was no difference in age distribution between cases with vertigo and those with dizziness(P=0.744>0.05).(3)There were 38 cases(8.4%)of triggered vestibular syndrome and 416 cases(91.6%)of spontaneous vestibular syndrome.There was a statistically significant difference in the proportion of triggered vestibular syndrome in cases with vertigo and those with dizziness(c2=6.766,P=0.009<0.05).(4)There were 16 cases(3.5%)of vertigo or dizziness lasting less than 1 minute,101 cases(22.3%)for several minutes,183 cases(40.3%)for several hours and 154 cases(33.9%)for periods longer than 24 hours.There was no difference in the distribution of symptom duration between cases with vertigo and cases with dizziness(P=0.538>0.05).(5)The incidence of accompanying symptoms ranged from high to low were: 227 cases(50.0%)of nausea,167 cases(36.8%)of vomiting,109 cases(24.0%)of walking instability,102 cases(22.5%)of ataxia,78 cases(17.2%)of limb numbness,67 cases(14.8%)of nystagmus,67 cases(14.8%)of headache,32 cases(7.0%)of tinnitus,10 cases(2.2%)of hearing loss and 5 cases(1.1%)of visual amaurosis.There were significant differences in the incidence of nausea,vomiting,ataxia,and nystagmus in cases with vertigo and cases with dizziness(P<0.05).(6)The incidence of past history and combined diseases ranged from high to low were: 297 cases(65.4%)of hypertension,230 cases(50.7%)of hyperlipidemia,213 cases(46.9%)of smoking history,115 cases(25.3 %)of diabetes,111 cases(24.4%)of hyperhomocysteinemia,100 cases(22.0%)of alcoholism,94 cases(20.7%)of cerebral infarction,57 cases(12.6%)of coronary heart disease and 14 cases(3.1%)of atrial fibrillation.There was a statistically significant difference in the incidence of hypertension in cases with vertigo and cases with dizziness(c2=5.369,P=0.021<0.05).(7)Compared with the normal value of blood flow velocity: the peak systolic velocity(PSV)of the middle cerebral artery(MCA)and anterior cerebral artery(ACA)was increased and the PSV of the posterior cerebral artery(PCA)and vertebral artery(VA)was reduced in cases with vertigo or dizziness under 40 years old.In cases with vertigo or dizziness aged 40~60 years,the PSV of MCA and ACA was increased,while the PSV of basilar artery(BA)was slowed.In cases with vertigo or dizziness over 60 years old,the PSV of MCA,ACA,PCA and BA was increased,while the PSV of VA was decreased.Comparison of vertigo group and dizziness group: There was a statistically significant difference in the PSV of PCA,VA and BA in cases with vertigo and cases with dizziness under 40 years old(P<0.05).There was a statistically significant difference in the PSV of PCA in cases with vertigo and cases with dizziness over 60 years old(P<0.05).(8)There were 366 cases(80.6%)with carotid plaque.There were 283 cases(62.3%)with cerebrovascular stenosis,including 60 cases(13.2%)of simple vertebrobasilar system stenosis,67 cases(14.8%)of simple carotid system stenosis,156 cases(34.4%)of carotid system and vertebrobasilar system stenosis.There were 223 cases(49.1%)of vertebrobasilar stenosis,170 cases(37.4%)of MCA stenosis,85 cases(18.7%)of internal carotid artery stenosis,49 cases(10.8%)of ACA stenosis,47 cases(10.4%)of PCA stenosis,42 cases(9.3%)of subclavian artery stenosis,20 cases(4.4%)of external carotid artery stenosis and 12 cases(2.6%)of common carotid artery stenosis.There were 183 cases(40.3%)of unevenly increased intima-media thickness of carotid artery,62 cases(13.7%)of development advantage of one side of VA,32 cases(7.0%)of congenital dysplasia of one side of VA,16 cases(3.5%)of VA course variation,12 cases(2.6%)of subclavian steal syndrome,3 cases(0.7%)of congenital dysplasia of ACA and 1 case(0.2%)of dysplasia of bilateral VA.The vertebrobasilar stenosis,development advantage of one side of VA,PCA stenosis,subclavian artery stenosis,congenital dysplasia of one side of VA,VA course variation,subclavian steal syndrome and dysplasia of bilateral VA were collectively referred to as vessel abnormity of vertebrobasilar system,there were 266 cases(58.6%)of vessel abnormity of vertebrobasilar system.There was a significant difference in the incidence of vertebrobasilar stenosis,simple vertebrobasilar system stenosis,MCA stenosis,simple carotid system stenosis and subclavian steal syndrome in cases with vertigo and cases with dizziness(P<0.05).Conclusion:Spontaneous Episodic Vestibular Syndrome was predominant in patients with vertigo/dizziness in neurology department.The most common accompanying symptoms were nausea and vomiting.The incidence of ataxia and nystagmus was higher in cases with vertigo than in cases with dizziness.Changes of cerebral blood flow velocity in patients with vertigo/dizziness mainly showed increased PSV of carotid artery system and decreased PSV of vertebrobasilar artery system.Differences in blood flow velocity between cases with vertigo and those with dizziness occured in the vertebrobasilar system.The cerebrovascular stenosis and vessel abnormity of vertebrobasilar system were important causes of vertigo and dizziness.The incidence of vertebrobasilar stenosis and simple vertebrobasilar system stenosis in cases with vertigo was higher than that in cases with dizziness.The incidence of simple carotid system stenosis and subclavian steal syndrome in cases with dizziness was higher than that of vertigo patients. |
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