Basilar Artery Tortuosity Increases the Risk of Persistent Dizziness and Unsteadiness After Posterior Circulation Infarction

IF 2.6 3区心理学 Q2 BEHAVIORAL SCIENCES

Brain and Behavior Pub Date : 2024-10-22 DOI:10.1002/brb3.70097

Jiashu Li, Xuesong Bai, Gaifen Liu, Zhaoxia Li, Yan Wang, Ruile Fang, Fei Peng, Xuge Chen, Yi Ju, Xingquan Zhao

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Abstract

Background and Purpose

Basilar artery (BA) tortuosity is closely associated with posterior circulation infarction (PCI) and dizziness/unsteadiness. This study aims to determine the relationship between BA tortuosity and the outcome of dizziness and unsteadiness in PCI patients.

Method

This study prospectively recruited PCI patients presenting with dizziness and unsteadiness. BA tortuosity was diagnosed based on Smoker's criteria. The BA tortuosity index (BATI) was measured from magnetic resonance angiography (MRA) images. Posterior circulation was divided into proximal (medulla oblongata and posterior inferior cerebellar), middle, and distal territories. Symptoms, risk of falls, and quality of life were followed up in 3 months after stroke. Logistic regression was used to identify possible factors associated with the persistence of dizziness and unsteadiness.

Results

Among 182 PCI patients presenting with dizziness and unsteadiness, 97 (53.3%) had BA tortuosity, including 19 (10.4%) with moderate-to-severe BA tortuosity. At the 3-month follow-up, 58 (31.9%) patients continued to experience dizziness and unsteadiness, with significantly decreased quality of life and a high risk of falls. Binary logistic regression analysis identified moderate-to-severe BA tortuosity (OR, 4.474; 95% CI, 1.591–12.579; p = 0.004) and lesions involving the proximal posterior circulation territory (OR, 2.146; 95% CI, 1.097–4.199; p = 0.026) as risk factors for persistent dizziness and unsteadiness after PCI, while thrombolysis (OR, 0.280; 95% CI, 0.079–0.992; p = 0.049) as a protective factor. BATI (OR, 1.072; 95% CI, 1.028–1.119; p = 0.001) was also independently associated with dizziness and unsteadiness after PCI.

Conclusion

Prominent BA tortuosity increases the risk of persistent dizziness and unsteadiness after PCI, leading to a high risk of falls and decreased quality of life. This warrants more attention in clinical practice.

Abstract Image

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基底动脉迂曲增加后循环梗死后持续头晕和不稳的风险

背景和目的：基底动脉（BA）迂曲与后循环梗死（PCI）和头晕/不稳密切相关。本研究旨在确定基底动脉迂曲与 PCI 患者头晕和不稳预后之间的关系：本研究前瞻性地招募了出现头晕和站立不稳的 PCI 患者。根据 Smoker 标准诊断 BA迂曲。根据磁共振血管造影（MRA）图像测量 BA 扭转指数（BATI）。后循环分为近端（延髓和小脑后下部）、中间和远端区域。对中风后 3 个月的症状、跌倒风险和生活质量进行了随访。采用逻辑回归法确定与持续头晕和站立不稳相关的可能因素：结果：在 182 名出现头晕和站立不稳的 PCI 患者中，97 人（53.3%）有动脉导管迂曲，其中 19 人（10.4%）有中度至重度动脉导管迂曲。在 3 个月的随访中，58 例（31.9%）患者仍有头晕和站立不稳的症状，生活质量明显下降，跌倒风险很高。二元逻辑回归分析确定了中重度 BA 扭曲（OR，4.474；95% CI，1.591-12.579；P = 0.004）和涉及近端后循环区域的病变（OR，2.146；95% CI，1.097-4.199；p = 0.026）为PCI后持续头晕和不稳的危险因素，而溶栓（OR，0.280；95% CI，0.079-0.992；p = 0.049）为保护因素。BATI（OR，1.072；95% CI，1.028-1.119；p = 0.001）也与PCI术后头晕和站立不稳独立相关：结论：明显的动脉导管迂曲会增加PCI术后持续头晕和站立不稳的风险，导致高跌倒风险和生活质量下降。这值得在临床实践中给予更多关注。

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来源期刊

Brain and Behavior BEHAVIORAL SCIENCES-NEUROSCIENCES

CiteScore

5.30

自引率

0.00%

发文量

352

审稿时长

14 weeks

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