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Otorinolaringologia 2004 September;54(3):149-58


language: Italian

Clinical diagnostic approach to vascular-induced dizziness. Classification aspects

Tirelli G., Meneguzzi C.

Istituto di Clinica ORL Università degli Studi di Trieste, Trieste


Aim. To propose a method for classifying patients suffering from vascular induced dizziness.
Methods. Between January 1999 and June 2003, 1975 cases of dizziness were treated at the Vestibology Section of the Ear, Nose and Throat clinic of the University of Trieste. A retrospective etiopathogenetic re-evaluation to classify these patients was begun in October 2003. For those cases in which it was not possible to reach a reliable diagnosis to explain the presence of dizziness symptomatology (number of cases=1039/1975), a method based on the clinical picture, the presence of cardiovascular risk factors, and the positiviy of neuroimaging techniques for cerebrovascular lesions, was employed for the identification and classification of vascular-induced dizziness cases.
Results. 1039 cases (1039/1975) in which clinical examination of the clinical file evidenced dizziness symptomatology similar to that of the pre-established clinical pictures were recruited. Of these, 362 patients (362/1039) were first selected as carriers of predetermined risk factors, and subsequently a further 63 patients (63/1039) because they presented a TC and/or magnetic resource positive for cerebrovascular lesions. The proposed application of the flowchart enabled 425 cases to be selected out of 1.039 dizziness patients.
Conclusion. The study identifies a classification protocol on a clinical-diagnostic basis which aims to select dizziness patients whose dizziness depends on a probably vascular cause. The identification and application of a standardised method for classifying a disease on an etiopathogenetic basis is the first step for determining and choosing an effective causal therapy. To diagnose dizziness due to a vascular cause means identifying patients whose cardiovascular apparatus must be monitored over time; in these patients the advisability of carrying out causal pharmacological treatment with the two-fold objective of reducing the onset of recurrences and cerebral ischemic complications will be evaluated.

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