ArticleFrontiers in neurology2025
Correlation between vascular stenosis severity and dizziness symptoms and neurological prognosis in elderly patients with acute ischemic stroke.
Article in Frontiers in neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Dizziness is a frequent complaint among elderly patients with acute ischemic stroke. However, its association with different grades and locations of arterial stenosis remains unclear. This study aimed to assess the links between stenosis severity, posterior circulation involvement, dizziness, and short-term neurological outcomes. Methods: A retrospective analysis was performed on 134 elderly patients with acute ischemic stroke admitted from January 2024 to May 2025. All patients underwent Computed Tomography Angiography (CTA) or MRA of the intracranial and extracranial arteries, including the common and internal carotid arteries, the middle cerebral artery, the vertebral artery (VA), and the basilar artery (BA). Stenosis of extracranial segments was measured with North American Symptomatic Carotid Endarterectomy Trial (NASCET) criteria, while intracranial segments were assessed using Warfarin-Aspirin Symptomatic Intracranial Disease Trial (WASID) standards. Patients were grouped by the most severely affected major supplying artery as mild (<50%), moderate (50-69%), or severe (≥70% or occlusion) stenosis. A separate vertebrobasilar artery (VA/BA) stenosis group included individuals with ≥50% stenosis of the vertebral or BA, regardless of anterior circulation status. Collected data included baseline characteristics, dizziness occurrence, Dizziness Handicap Inventory (DHI) scores, admission National Institutes of Health Stroke Scale (NIHSS) scores, and 3-month modified Rankin Scale (mRS) scores. Univariate and multivariate logistic regression analyses were conducted to identify risk factors. Results: The severe stenosis group and the VA/BA stenosis group showed higher dizziness rates than the other groups (44.9 and 50.0%, Conclusion: In elderly patients with acute ischemic stroke, severe arterial stenosis and VA/BA stenosis were linked to higher risks of dizziness and 3-month functional dependence. Posterior circulation infarction markedly increased the likelihood of dizziness. Enhanced vascular imaging assessment and attention to symptoms such as dizziness may help identify high-risk individuals and support personalized management.
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