PT - JOURNAL ARTICLE AU - Dong Hwan Lee AU - Won Young Kim AU - Byoung Soo Shim AU - Tae Su Kim AU - Joong Ho Ahn AU - Jong Woo Chung AU - Tae Hyun Yoon AU - Hong Ju Park TI - Characteristics of central lesions in patients with dizziness determined by diffusion MRI in the emergency department AID - 10.1136/emermed-2013-202674 DP - 2014 Aug 01 TA - Emergency Medicine Journal PG - 641--644 VI - 31 IP - 8 4099 - http://emj.bmj.com/content/31/8/641.short 4100 - http://emj.bmj.com/content/31/8/641.full SO - Emerg Med J2014 Aug 01; 31 AB - 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.