Introduction: Vertigo, characterized by a sensation of spinning or
movement, presents as a common complaint in primary care, emergency
departments, neurology, psychiatry, and otolaryngology clinics. Its
diverse etiologies, including inner ear disorders and neurological
conditions, pose diagnostic challenges. The diagnostic process typically
involves a comprehensive neurological examination, but additional tests
like vertebral artery Doppler examination may be necessary, particularly
when vascular causes are suspected. However, the necessity of this
examination remains unclear. In this retrospective study, we aimed to
evaluate the necessity of vertebral artery Doppler/USG examination in
patients presenting with vertigo.
Methods: A cohort of 1021 patients attending a neurology outpatient
clinic with complaints of dizziness/vertigo underwent comprehensive
evaluation, including vertebral artery ultrasound/Doppler examination.
Results: The study revealed that the majority of patients (about 90%)
exhibited no evidence of significant vertebral artery atherosclerosis.
However, hemodynamically significant vertebral artery pathology
was observed in 5.1% of patients, predominantly among older male
individuals with cardiovascular risk factors. Additionally, anatomical
variations in vertebral artery anatomy were noted, highlighting the
importance of considering vascular factors in vertigo evaluation.
Conclusion: These findings underscore the importance of tailored
diagnostic approaches and comprehensive assessment in patients with
vertigo, emphasizing the role of vertebral artery Doppler examination,
particularly in specific patient subgroups. Over 60-year-old patients with
vertigo are likely to have hemodynamically important vertebral artery
atherosclerotic lesions and clinicians should keep this information in
mind during daily practice. Understanding the necessity of this adjunctive
diagnostic tool can aid in timely diagnosis and management, potentially
reducing healthcare costs and optimizing patient outcomes. However,
this examination may not be necessary in 90% of vertigo patients.
Keywords: Dizziness, Doppler USG, elder patients, vertebral artery, vertigo