Evaluation of patients presenting to the emergency department with complaints of dizziness and undergoing neuroimaging (brain CT and/or MR diffusion)

Introduction: The lack of a specific definition for the complaint of dizziness, its subjective variability encompassing sensations such as lightheadedness, weakness, imbalance, difficulty in maintaining balance, and a sensation of spinning, when considering the working environment of the emergency department, challenges the physician's decision-making process and leads to an increase in diagnostic investigations. The primary objective of this study is to determine the rates of neuroimaging performed on patients presenting to the emergency department with complaints of dizziness and to identify the detected pathologies, evaluating the impact of neuroimaging on patient outcome decisions. As a secondary objective, the study aims to identify characteristics of patients with detected pathologies and explore features predicting a more cost-effective approach to neuroimaging in specific patient groups. Materials and Methods: 578 patients who presented to the Emergency Department of Akdeniz University Hospital between January 1, 2021, and January 1, 2022, with complaints of dizziness and underwent neuroimaging, were retrospectively evaluated by retrieving data from the hospital information management system. Findings: The study revealed that 46.4% (n=268) of the included patients were male, while 53.6% (n=310) were female, with an average age of 58.84 ±18.31. Among the patients, 18.7% exhibited symptoms indicative of central vertigo, and 23.4% showed pathological findings during physical examination. It was observed that the presence of these findings in the history and examination resulted in a statistically significant difference in terms of experiencing recurrent cerebrovascular disease within three months. Additionally, the identification of pathological findings in imaging and advanced age were found to be significant in terms of the risk of cerebrovascular disease occurrence. Comorbidities such as hypertension, diabetes mellitus, coronary artery disease, and atrial fibrillation did not show an impact on the development of SVH. Regression analysis indicated that gait disturbance, lateralizing deficits, and visual impairment were significantly associated with cerebrovascular disease, whereas age and the presence of accompanying diseases were not statistically significant Conclusion: In patients presenting to the hospital with complaints of dizziness, advanced age, positive examination findings, and pathological findings on imaging are significant indicators for cerebrovascular disease. Keywords: Computerized tomography, emergency medicine physician, Dizziness, vertigo, Magnetic resonance imaging