Medicina Fluminensis, Vol. 60 No. 4, 2024.
Pregledni rad
https://doi.org/10.21860/medflum2024_321517
Guidelines for Management of Patients with Vertigo in the Emergency Medicine
Ivan Adamec
orcid.org/0000-0003-3873-6526
; Klinički bolnički centar Zagreb, Klinika za neurologiju, Zagreb, Hrvatska
*
Luka Crnošija
; Klinički bolnički centar Zagreb, Klinika za neurologiju, Zagreb, Hrvatska
Adis Keranović
; Klinički bolnički centar Zagreb, Objedinjeni hitni bolnički prijam, Zagreb, Hrvatska
Ana Abičić
; Opća bolnica Zabok, Odjel za neurologiju, Zabok, Hrvatska
Nikola Blažević
; Klinički bolnički centar Zagreb, Klinika za neurologiju, Zagreb, Hrvatska
Iva Milivojević
; Specijalna bolnica za medicinsku rehabilitaciju Krapinske Toplice, Služba za fizikalnu medicinu i rehabilitaciju, Krapinske Toplice, Hrvatska
Mario Habek
; Klinički bolnički centar Zagreb, Klinika za neurologiju, Zagreb, Hrvatska; Sveučilište u Zagrebu, Medicinski fakultet, Zagreb, Hrvatska
* Dopisni autor.
Sažetak
Vertigo is a common cause of patient’s examination in the emergency department. The differential diagnosis of acute vertigo can be challenging: the term vertigo is often used for different symptoms that include vestibular lesion, but also systemic diseases; the differential diagnosis of vertigo can be very broad and includes central and peripheral causes; there is often no specific diagnostic test that will confirm the exact etiology of vertigo in the emergency room. Therefore, there is a need for the development of guidelines for managing patients with vertigo in the emergency department. The approach to a patient with vertigo is based on the history taking, with the aim of identifying which type of vertigo it is present based on the time of onset, duration of symptoms and the presence of a trigger. We can divide vertigo into: (1) acute vestibular syndrome, (2) triggered episodic vestibular syndrome and (3) spontaneous episodic vestibular syndrome. Within these types of vertigo, we distinguish the two most common differential diagnoses based on further examination: (1) vestibular neuritis and cerebellar infarction, (2) benign paroxysmal positional vertigo and central positional vertigo, and (3) vestibular migraine/Meniere’s disease and transitory ischemic attack. In the setting of the emergency department, it is important to distinguish self-limiting causes of vertigo such as vestibular neuritis and benign paroxysmal positional vertigo from dangerous causes such as stroke. Despite the development and availability of neuroradiological tests, the correct diagnosis of vertigo is primarily based on history and clinical examination.
Ključne riječi
benign paroxysmal positional vertigo; emergency service, hospital; stroke; vertigo; vestibular neuronitis
Hrčak ID:
321517
URI
Datum izdavanja:
1.12.2024.
Posjeta: 597 *