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Research in Vestibular Science > Volume 13(2); 2014 > Article
Research in Vestibular Science 2014;13(2): 34-40.
어지럼으로 응급실에 내원한 환자의 중추성 원인에 대한 예측인자들: ABCD2 스코어의 유용성
, , , , , 김형준1, 김수익1, 강지훈1, 성기범3, 이태경3, 박지윤2
서남대학교 의과대학 예수병원 1응급의학과학교실, 2신경과학교실, 3순천향대학교 의과대학 순천향대학교 부천병원 신경과학교실
Predictors of Cerebrovascular Causes in the Emergency Department Patients with Dizziness: Application of the ABCD2 Score
Hyung Jun Kim, Su Ik Kim, Ji Hun Kang, Ki Bum Sung, Tae Kyeong Lee, Ji Yun Park
1Department of Emergency Medicine, Presbyterian Medical Center, Seonam University College of Medicine, Jeonju, Korea.
2Department of Neurology, Presbyterian Medical Center, Seonam University College of Medicine, Jeonju, Korea. truejy@jesushospital.com
3Department of Neurology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea.
Background and Objectives:   Dizziness is a common presenting complaint in the emergency department (ED) that had various pathologic causes. Most of dizziness can be caused by benign origin but identifying cerebrovascular causes among ED patients with dizziness is a diagnostic challenge. ABCD2 score is clinical prediction tool for assessing the risk of stroke after a transient ischemic attack (TIA). We evaluated predictors of cerebrovascular causes and whether ABCD2 score would identify cerebrovascular events among ED patients with dizziness.
Materials and Methods:  
We analyzed 180 patients (≥20 years old) with dizziness in ED, Presbyterian Medical Center (single-center prospective observational study) for 2 months. Type of dizziness, associated symptoms, past medical history, ABCD2 score (0−7), neuro-otologic examination, diagnosis were recorded.
The incidence of dizziness is 3.6% (192/5,374). After excluding 12 patients, 180 patients (56% female, mean 59 years) met our eligibility criteria and were included in the final analysis. Cerebrovascular causes of dizziness were found in 10% (18/180): 3 vertebrobasilar insufficiency, 9 cerebellar infarction, 1 right middle cerebral artery (MCA) infarction, 1 right MCA giant aneurysm, 1 lateral medullary infarction, 1 posterior limb of internal capsule infarction, 1 intracerebral hemorrhage of cerebellum. Patients with cerebrovascular cause were males and had more hypertension, diabetes mellitus, imbalance, abnormal neuro-otologic findings and ABCD2 score.
Several clinical factors (hypertension, diabetes, abnormal neuro-otologic findings ABCD2 scores) favored a diagnosis of central neurological causes of dizziness. ABCD2 score is a simple and easily applied tool for distinguishing cerebrovascular from peripheral causes of dizziness in ED.
Keywords: Dizziness; Stroke; Emergency medicine
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