RT Journal Article
SR Electronic
T1 Characteristics of central lesions in patients with dizziness determined by diffusion MRI in the emergency department
JF Emergency Medicine Journal
JO Emerg Med J
FD BMJ Publishing Group Ltd and the British Association for Accident & Emergency Medicine
SP 641
OP 644
DO 10.1136/emermed-2013-202674
VO 31
IS 8
A1 Dong Hwan Lee
A1 Won Young Kim
A1 Byoung Soo Shim
A1 Tae Su Kim
A1 Joong Ho Ahn
A1 Jong Woo Chung
A1 Tae Hyun Yoon
A1 Hong Ju Park
YR 2014
UL http://emj.bmj.com/content/31/8/641.abstract
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.