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ORIGINAL RESEARCH article

Front. Stroke
Sec. Preventative Health and Stroke Complications
Volume 3 - 2024 | doi: 10.3389/fstro.2024.1429068
This article is part of the Research Topic Stroke and Balance Disorders View all 10 articles

Vertigo and Dizziness due to Vertebrobasilar TIA: A prospective study

Provisionally accepted
Arlindo C. Neto Arlindo C. Neto 1*Ji Soo Kim Ji Soo Kim 2Wanderley M. Bernardo Wanderley M. Bernardo 1Roseli S. Bittar Roseli S. Bittar 1
  • 1 University of São Paulo, São Paulo, Brazil
  • 2 Seoul National University, Seoul, Republic of Korea

The final, formatted version of the article will be published soon.

    Purpose: Prospectives studies on vascular vertigo and dizziness (VVD) due to vertebrobasilar TIA (VBTIA) have been sparse. This study aimed to characterize the clinical features, response to treatments, and prognostic factors of VVD due to VBTIA using a cohort established in 2021. Methods: We recruited 103 patients (58 women, 56.3%) with a mean age of 70.9± 9.3 years (range = 37 ~ 85) between January 2021 and January 2024. All patients met the diagnostic criteria of "Probable transient VVD" published by the Barany Society. The mean interval from the symptom onset to recruitment was 11.8 months (range = 0.5 ~ 72). Treatments followed the current Guidelines for Prevention of Stroke in Patients with Stroke and TIA (AHA-ASA).Patients with recurrent strokes among TIAs, and patients who were already taking an antithrombotic agent and should maintain the same regimen were excluded. Results: Imbalance (46.7%) and vertigo (39.8%) were the most frequent symptoms. The duration of attacks was < 1 minute in 35 (33.9%), 1-10 minutes in 34 (33.0%), 10-60 minutes in 15 (14.6%), and > 60 minutes in 19 (18.5%) patients. Trigger factors were reported in 20 (19.4%) patients, which included eccentric neck position in 12 (11.7%), physical exercise in 4 (3.9%), positional changes in 3 (2.9%), and eccentric neck position plus physical exercise in the remaining one (0.9%). The frequency of attacks before the medication was single or less than 1/month in 32 (31.0%), 1-4/month in 44 (42.7%), 4-8/month in 21 (20.4%), and daily in 6 (5.9%) patients. The treatment regimens were aspirin in 57 (55.3%), clopidogrel in 19 (18.5%), aspirin+clopidogrel in 25 (24.3%), and rivaroxaban in 2 (1.9%) patients. The attacks were reduced by 93.2% (IC 95%, 88.34, during the median follow-up of 12 months (range = 2 ~ 36). Only 7 (6.8%) patients experienced a new attack with the medication. No prognostic factors could be identified for the recurrences. Conclusion: VVD due to VBTIA has a broad clinical spectrum. The secondary stroke prevention is effective in VVD due to VBTIA even though no prognostic factors could be identified for the recurrences of the symptoms.

    Keywords: TIA, vascular, Vertigo, Dizziness, Treatment, Vertebrobasilar, cohort

    Received: 07 May 2024; Accepted: 09 Sep 2024.

    Copyright: © 2024 Neto, Kim, Bernardo and Bittar. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Arlindo C. Neto, University of São Paulo, São Paulo, Brazil

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