Sestre Milosrdnice University hospital and Institute of Clinical Medical Research
Abstract
Vrtoglavica je učestali problem u neurološkoj praksi uzrokovan nizom patomorfoloških i patofizioloških supstrata. Cilj istraživanja bio je utvrditi učestalost pojedinih uzroka vrtoglavice u neurološkoj praksi. Provedeno je prospektivno istraživanje uzroka vrtoglavice u bolesnika obrađivanih u neurološkoj ambulanti. U statističkoj obradi rabili smo χ²-test, t-test, analizu varijance i post hoc LSD test. Srednja životna dob oboljelih muškaraca bila je 55,45±14,8 godina, a žena 52,9±15,1 godinu. Utvrdili smo da podjednako obolijevaju muškarci i žene (t=0,92; p=0,36). Najčešći uzrok vrtoglavice bila je vertebrobazilarna insuficijencija i tranzitorna ishemijska ataka vertebrobazilarnog sliva (36,5%), a slijedili su prema učestalosti vestibularni neuritis (23,5%) i moždani udar (14,8%) te tranzitorna ishemijska ataka uzrokovana značajnim stenozama karotidnih arterija (9,6%). Ostali znatno rjeđi uzroci vrtoglavice u neurološkoj praksi bili su benigna paroksizmalna pozicijska vrtoglavica, multipla skleroza, upalni procesi srednjeg uha, tumori mozga i akustični neurinomi. Utvrđena je statistički značajna razlika uzroka vrtoglavice s obzirom na patomorfološki supstrat prema dobi bolesnika (f=3,55; p=0,017). Oboljeli od moždanog udara i oni s tranzitornom ishemijskom atakom uzrokovanom značajnom stenozom karotidnih arterija bili su značajno starije životne dobi. Posebna pomoć u dijagnostici pojedinih uzroka vrtoglavice uz dijagnostičke metode su pridruženi simptomi te težina, trajanje i tijek vrtoglavice, o čemu treba voditi računa pri procjeni mogućih uzroka vrtoglavice.Vertigo is a common problem in neurological practice, caused by a number of pathomorphological and pathophysiological substrates. The aim of the study was to assess the incidence of particular causes of vertigo in neurological practice. This prospective study included patients treated for vertigo at neurology outpatient clinic. On statistical analysis, χ2-test, t-test, analysis of variance and post hoc LSD test were used. The mean age was 55.45±14.8 years in male patients and 52.9±15.1 years in female patients. The incidence of vertigo was comparable in the two sexes (t=0.92, p=0.36). The most common cause of vertigo was vertebrobasilar insufficiency and transient ischemic attack of the vertebrobasilar circulation (36.5%), followed by vestibular neuritis (23.5%), stroke (14.8%) and transient ischemic attacks caused by significant carotid artery stenosis (9.6%). Other, more infrequent causes of vertigo in neurology practice were benign paroxysmal positional vertigo, multiple sclerosis, inflammation processes in the middle ear, brain tumors and acoustic neuroma. There was a statistically significant difference in the causes of vertigo according to pathomorphological substrate and patient age (f=3.55; p=0.017). The patients that had suffered a stroke and those with transient ischemic attacks caused by significant carotid artery stenosis were significantly older. Besides established diagnostic methods, associated symptoms, severity, duration and course of vertigo are of great help in the diagnosis of particular causes of vertigo, which should be taken in consideration on assessing the possible causes of vertigo
