Transient Ischemic Attacks Presenting with Dizziness or Vertigo

Christina A Blum; Scott E Kasner

doi:10.1016/j.ncl.2015.04.005

Transient Ischemic Attacks Presenting with Dizziness or Vertigo

Neurol Clin. 2015 Aug;33(3):629-42, ix. doi: 10.1016/j.ncl.2015.04.005. Epub 2015 Jun 12.

Authors

Christina A Blum¹, Scott E Kasner²

Affiliations

¹ Department of Neurology, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA.
² Department of Neurology, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA. Electronic address: kasner@mail.med.upenn.edu.

PMID: 26231276
DOI: 10.1016/j.ncl.2015.04.005

Abstract

Dizziness with or without associated neurologic symptoms is the most common symptom of posterior circulation transient ischemic attack (TIA) and can be more frequent before posterior circulation strokes. This entity carries a high risk of recurrent events and should be considered as a potential cause of spontaneous episodic vestibular syndrome. Diagnostic evaluation should include intracranial and extracranial imaging of the vertebral arteries and basilar artery. Aggressive medical management with antiplatelet therapy, statin use, and risk factor modification is the mainstay of treatment. This article highlights the importance of diagnosing, evaluating, and treating posterior circulation TIAs manifesting as dizziness or vertigo.

Keywords: Dizziness; Posterior circulation; Stroke; Transient ischemic attack; Vertebrobasilar insufficiency; Vertigo.

Publication types

Case Reports
Review

MeSH terms

Aged
Atherosclerosis / complications
Dizziness / diagnosis*
Dizziness / etiology
Ear, Inner / blood supply
Female
Humans
Ischemic Attack, Transient / complications
Ischemic Attack, Transient / diagnosis*
Ischemic Attack, Transient / therapy
Risk Factors
Stroke / complications
Stroke / diagnosis*
Stroke / therapy
Vertigo / diagnosis*
Vertigo / etiology