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Characteristics of central lesions in patients with dizziness determined by diffusion MRI in the emergency department
  1. Dong Hwan Lee1,3,
  2. Won Young Kim2,
  3. Byoung Soo Shim1,4,
  4. Tae Su Kim1,5,
  5. Joong Ho Ahn1,
  6. Jong Woo Chung1,
  7. Tae Hyun Yoon1,
  8. Hong Ju Park1
  1. 1Department of Otolaryngology, Asan Medical Center, University of Ulsan, Seoul, Republic of Korea
  2. 2Department of Emergency, Asan Medical Center, University of Ulsan, Seoul, Republic of Korea
  3. 3Department of Otolaryngology, GuroSungshim Hospital, Seoul, Republic of Korea
  4. 4Department of Otolaryngology, Jeju Seogwipo Medical Center, Jeju, Republic of Korea
  5. 5Department of Otolaryngology, Kangwon National University, Chuncheon, Republic of Korea
  1. Correspondence to Hong Ju Park MD PhD, Department of Otolaryngology, Asan Medical Center, University of Ulsan, College of Medicine, Asanbyeongwon-gil 86, Songpa-gu, Seoul 138-736, Republic of Korea; dzness{at}


Background To describe the rate and risk factors of central lesions among patients with dizziness in the emergency department based on diffusion-weighted MRI, which otologists consulted for evaluation of patients with dizziness need to know.

Methods 902 Consecutive patients who presented with dizziness symptoms as a chief complaint in the emergency department (ED) of our tertiary referral centre between January 2011 and June 2011 were studied. Central lesions were confirmed by diffusion-weighted MRI. Univariate and multivariate analyses were used for factors predictive of central lesions.

Results Of 645 patients who underwent MRI, 23 (3.6%) had acute central lesions (22 infarcts/1 haemorrhage). Univariate analyses revealed that older age, hypertension, atrial fibrillation, non-whirling type of dizziness symptoms and combined neurological symptoms were significantly associated with the development of central lesions (p<0.05). The incidence of central lesions in patients aged in their 40s, 50s, 60s, 70s and ≥80s was 0, 3.9%, 3.4%, 7.4% and 16.7%. Multivariate analyses showed that hypertension (p=0.01, OR=3.42), symptoms of non-whirling type (p=0.03, OR=3.12) and combined neurological symptoms (p<0.01, OR=16.72) were independent predictors of central lesions.

Conclusions Although dizziness in the ED is generally benign, the prevalence of acute central lesions was 3.6% among 645 patients with dizziness who underwent MRI. Old age (>50 years), hypertension, non-whirling type of dizziness symptoms and associated neurological symptoms were significant risk factors for central lesions.

  • imaging, CT/MRI

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