급성 어지럼증으로 대학병원 응급실을 방문한 환자에서 뇌자기공명영상의 진단적 유용성

Abstract

Background: Dizziness is one of the most common neurological symptoms for visiting the emergency department. Acute vertigo and severe imbalance may be the only presenting features of cerebellar stroke that could masquerade as a peripheral vestibular lesion. Magnetic resonance images (MRI) proved to be very sensitive in detecting acute stroke involving brainstem or cerebellum. In this retrospective study, we investigated the diagnostic yield of emergency brain MRI among the patients who visited emergency department with acute dizziness. Methods: We reviewed the medical records of consecutive patients with acute dizziness who were seen in emergency department of Cheju National University Hospital between May 2005 and Oct 2006. We collected following the information from medical records. (1) Age, sex, and blood pressure at emergency department (2) Type, duration, accompanying symptoms of dizziness and positive finding from neurological and neuro-otological examination (3) Vascular risk factors (4) Results of MRIs. Results: During the study period, 360 patients visited emergency department due to isolated acute dizziness. Emergent MRIs were performed in 84 (23.3%) patients. Although about 90% of them were older than 50 years and 60% of them had at least one or more vascular risk factors, central causes of dizziness were found in only five patients including four acute cerebellar infarctions and a cerebellar hemorrhage. Diagnostic yield of emergent MRI was only 6%. Conclusions: In this study, emergency brain MRIs showed limited diagnostic yield among patients who visited emergency department with acute isolated dizziness.