Zhongguo quanke yixue (May 2024)
Clinical Characteristics and Related Factors of Patients with Cerebral Infarction in Acute Vestibular Syndrome
Abstract
Background Acute cerebral infarction is a critical condition in patients with acute vestibular syndrome (AVS). AVS presents suddenly with severe symptoms. The sensitivity of CT in diagnosing acute cerebral infarction is low, and MRI, which is more accurate, is not always immediately available. This makes the diagnosis of acute cerebral infarction presenting as AVS challenging. Therefore, it is necessary to explore suitable examination and evaluation methods for patients with AVS. Objective To analyze the risk factors associated with acute cerebral infarction in patients with AVS, in order to provide a reference for the diagnosis of acute cerebral infarction in AVS and to maximize the critical treatment window for these patients. Methods A total of 102 patients with AVS admitted to the Department of Neurology, the Fourth Hospital of Harbin Medical University from April 2021 to July 2022 were included in the study. Clinical signs were recorded, and MRI results were used as the gold standard for the diagnosis of cerebral infarction. Patients were divided into the cerebral infarction group (n=16) and non-cerebral infarction group (n=86). The clinical characteristics of the two groups were compared. Univariate and multivariate Logistic regression analyses were used to explore factors influencing the occurrence of cerebral infarction in AVS. Receiver operating characteristic (ROC) curves were plotted to evaluate the predictive value of these factors. Results The proportions of patients with a history of smoking, alcohol consumption, positive Head-Impulse-Nystagmus-Test-of-Skew (HINTS) tests, and higher ABCD2 scores were significantly higher in the cerebral infarction group (P<0.05). Univariate Logistic regression analysis indicated that positive HINTS, ABCD2 scores, history of smoking, alcohol consumption, and hearing loss were factors influencing the occurrence of cerebral infarction. Multivariate analysis showed that positive HINTS (OR=99.043, 95%CI=8.120-1 208.090) and ABCD2 scores (OR=2.820, 95%CI=1.188-6.696) were the influencing factors (P<0.05). The areas under the ROC curve (AUC) for predicting cerebral infarction using combined indicators, positive HINTS, ABCD2 scores, history of smoking, alcohol consumption, and hearing loss were 0.949, 0.874, 0.734, 0.643, 0.649, and 0.604, respectively. Conclusion The proportion of non-cerebral infarction is higher in patients with AVS, with vestibular neuritis being the most common. Positive HINTS and ABCD2 scores are closely related to the occurrence of cerebral infarction in patients with AVS.
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