Etiological diagnoses of vertebrobasilar insufficiency with dizziness in 773 patients over a 10-year period in Suzhou, China | Hu | Pakistan Journal of Medical Sciences Old Website

Etiological diagnoses of vertebrobasilar insufficiency with dizziness in 773 patients over a 10-year period in Suzhou, China

Xiaowei Hu, Qi Fang, Xia Yuan, Zhengchun Zhang, Wanli Dong


Objective: Dizziness and vertigo were common but nonspecific symptoms of vertebrobasilar insufficiency (VBI), while out-of-date VBI has been falsely considered the major cause of dizziness symptoms by many clinicians in China. The objective of this study was to re-evaluate etiological diagnosis of VBI with dizziness symptoms among the hospitalized patients during the past 10 years.
Methodology: Retrospectively searched patients with the diagnosis of VBI in the in-patient database of the First Affiliated Hospital of Soochow University, China from January 1997 to December 2007. The original medical information were examined by the neurological specialists or combined with other specialists (such as otological specialists and cardiac specialists). The terms of dizziness symptoms and the diagnoses of related diseases were strictly distinguished.
Results: Seven hundred and seventy three patients were entered in the study. Five hundred and forty five patients (70.50%) were from Department of Neurology. After re-assessment, 462 (59.77%) cases had vertigo as chief complaint. Sixty seven (8.67%) met diagnostic criteria of vertebrobasilar TIA. Forty one patients (5.30%) were attributed to benign paroxysmal positional vertigo. There were 35 cases of Meniere’s disease, 26 cases of heart diseases, 26 cases caused by abnormal blood pressure, 25 cases of psychological disorders, 21 cases of infectious diseases, 20 cases of syncope, 17 cases of sudden deafness, 11 cases of vestibular neuronitis, 7 cases of other ear diseases, 6 cases of migrainous vertigo and 5 cases of vertebrobasilar infarction. Thirty four were diagnosed as other diseases (6 cases of cervical osteoarthritis, 5 cases of brain trauma, 5 cases of encephalitis, 4 cases of intracranial hypotension syndrome, 4 cases of climacteric syndrome, 3 cases of old cerebral infarction, 2 cases of anemia, 2 cases of electrolyte disturbances, one case of multiple sclerosis, one case of hypoglycemia and one case of acute alcoholism). Four hundred and thirty two (55.89%) in total incredibly remained undiagnosed because of incomplete clinical information.
Conclusions: Serious exaggeration of VBI, confusion of dizziness symptoms and other related diseases lead to the abuse of VBI. VBI is not supposed to be used again. It’s necessary to renew knowledge on VBI and dizziness symptoms, offer correct diagnosis and treatment to patients. The limitations addressed here are the retrospective design and more than 55% cases without definitive diagnosis.

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