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Predictors of false negative diffusion-weighted MRI in clinically suspected central cause of vertigo

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dc.contributor.authorDENİZBAŞI ALTINOK, ARZU
dc.contributor.authorsAkoglu, Ebru Unal; Akoglu, Haldun; Ozturk, Tuba Cimilli; Onur, Bahaeddin; Eroglu, Serkan Emre; Onur, Ozge; Denizbasi, Arzu
dc.date.accessioned2022-03-12T22:27:09Z
dc.date.available2022-03-12T22:27:09Z
dc.date.issued2018
dc.description.abstractIntroduction: Vertigo is classified as peripheral and central. Differentiation of stroke mimics is the most important diagnostic challenge. There is no clinical guidance for the indications of neuroimaging in isolated vertigo patients. The primary aim of this study is to test the diagnostic value of a DWI-MRI protocol to rule-out a central cause in patients with acute isolated vertigo in the ED. Methods: We prospectively enrolled 144 patients who were presented with isolated vertigo to the ED. A detailed neurological examination and maneuvers were performed for differential diagnosis. All patients underwent CT and/or DW-MRI either during ED visit or at the follow-up, if necessary. Out-patient follow-up exams and evaluations were repeated until all patients had a definitive diagnosis. Results: In the study, 137 of the 144 patients completed the follow-up period, and 34 of 137 patients were diagnosed with central vertigo. Six of 34 central vertigo patients had normal DW-MRI findings. One was diagnosed with migraine headache and five with vertebra-basilar insufficiency during the out-patient follow-up. One of the 28 patients with a pathological MRI was diagnosed with mass and the rest was stroke. The utility of DW-MRI in vertigo patients was moderately high (sensitivity: 82%, specificity: 100%). We found that age, history of HT, history of CAD and vertigo unresponsive to ED treatment were significantly associated with a central cause of vertigo. Conclusion: We suggest that unresponsiveness to ED treatment, especially in patients with a history of HT and CAD, should alert physicians for central causes and warrant DW-MRI imaging. (C) 2017 Elsevier Inc. All rights reserved.
dc.identifier.doi10.1016/j.ajem.2017.09.038
dc.identifier.eissn1532-8171
dc.identifier.issn0735-6757
dc.identifier.pubmed28974371
dc.identifier.urihttps://hdl.handle.net/11424/235166
dc.identifier.wosWOS:000431713500015
dc.language.isoeng
dc.publisherW B SAUNDERS CO-ELSEVIER INC
dc.relation.ispartofAMERICAN JOURNAL OF EMERGENCY MEDICINE
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.subjectVertigo
dc.subjectDizziness
dc.subjectDW-MRI
dc.subjectDiagnostic accuracy
dc.subjectACUTE ISCHEMIC-STROKE
dc.subjectEMERGENCY-DEPARTMENT
dc.subjectDIZZINESS
dc.subjectIMBALANCE
dc.subjectYIELD
dc.subjectCT
dc.subjectINFARCTION
dc.subjectDIAGNOSIS
dc.titlePredictors of false negative diffusion-weighted MRI in clinically suspected central cause of vertigo
dc.typearticle
dspace.entity.typePublication
local.avesis.id5407aadf-a1b5-42a4-9535-a76f3d223f17
local.import.packageSS17
local.indexed.atWOS
local.indexed.atSCOPUS
local.indexed.atPUBMED
local.journal.numberofpages5
local.journal.quartileQ2
oaire.citation.endPage619
oaire.citation.issue4
oaire.citation.startPage615
oaire.citation.titleAMERICAN JOURNAL OF EMERGENCY MEDICINE
oaire.citation.volume36
relation.isAuthorOfPublication85d7879a-b827-49ad-8b5f-77e6661077c7
relation.isAuthorOfPublication.latestForDiscovery85d7879a-b827-49ad-8b5f-77e6661077c7

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