Evaluating the morphological changes of intracranial arteries and whole-brain perfusion in undetermined isolated vertigo

- UIV refers to undetermined IV.
- The morphological changes of intracranial arteries and whole-brain perfusion are not clear in UIV patients.
- 320-detector row CT system can evaluate the vascular information and perfusion regions of the whole-brain.
- Unusual morphology of intracranial VBA and hypoperfusion should raise suspicion concerning the etiology in UIV patients with multiple VRFs.

PurposeTo determine the morphological changes of intracranial arteries and whole-brain perfusion in undetermined isolated vertigo (UIV) patients using 320-detector row computed tomography (CT).MethodsA total of 150 patients who underwent CT angiography (CTA) and CT perfusion (CTP) imaging were divided into UIV group and benign paroxysmal positional vertigo (BPPV) group. Sixty individuals with sex- and age-matched without vertigo and cerebral diseases served as the control. The morphological changes of intracranial arteries, perfusion parameters and vascular risk factors (VRFs) were analyzed, calculated and compared.ResultsIn UIV patients, hypertension (HT), hyperlipidemia and number of VRFs ≥ 3 occurred more commonly (P < 0.0125, respectively). The incidence of vertebral artery dominance (VAD), vertebral artery stenosis (VAS) and basilar artery curvature (BAC) were significantly higher (P < 0.0125, respectively). HT was an independent risk predictor of non-VAD (OR: 5.411, 95%CI: 1.401; 20.900, P = 0.014). HT and VAD associated with BAC served as risk predictors (OR: 4.081, 95%CI: 1.056;15.775, P = 0.041 and OR: 6.284, 95%CI: 1.848; 21.365, P = 0.003, respectively). The absolute difference in relative values of CTP parameters from cerebellum and brainstem were significantly different (P < 0.05), and hypoperfusion was found in the territories of the non-VAD side and the BAC cohort (P < 0.05, respectively).ConclusionsOn the basis of multiple VRFs, morphological changes of vertebrobasilar artery (VBA) and the unilateral hypoperfusion of the cerebellum and brainstem, that acts as a herald for IV occurrence, which should be paid cautious attention to UIV patients.