Importance of levels of blood C-Reactive protein, D-Dimer and fibrinogen in differantial diagnosis of central and peripheric vertigo

IMPORTANCE OF LEVELS OF BLOOD C-REACTIVE PROTEIN, D-DIMER ANDFIBRINOGEN IN D FFERANTIAL DIAGNOSIS OF CENTRAL AND PERIPHERICVERTIGODR.EM NE AKINCIVertigo is a frequently encountered symptom at emergency medicine services.Differantial diagnosis and threatment of it is highly difficult. In differantial diagnosis ofVertigo, there are some studies suggesting that serological determinants can also be usedbesides of hystory, physical examination and certain diagnosis tests.Purpose of our study is: to show whether or not, Fibrinogen and D-Dimer as beingtwo of the hemostatic system determinants and CRP as being one of the inflammationdeterminants, have any helpful importance in differatial diagnosis-peripheral andcentral vertigo work-up.116 patients who had study criterions and who accepted to participate this studywere investigated. Central and Peripheral vertigo work-up were carried out on thosepatients with the help of their historical past, physical examination, diagnosis tests andconsultations. Levels of CRP, Fibrinogen, and D-Dimer were measured for thosepatients. Beside of those, the importance of levels of CRP, Fibrinogen, and D-Dimer wastried to be defined.Among those patients who participated to this study, 65.5% were female, 34.5%were male. Their average age was 48.7 (18-85 years old). 83.6% of the patients hadperipheral vertigo and 16.4% had central vertigo.1While the average D-Dimer levels of patients with peripheral vertigo was176.5 +126.2 µg/L, this value was 209.7 + 160.7 µg/L for the patients with central vertigo. Theaverage CRP level of patients with peripheral vertigo determined as 3.8 + 8.76 mg/L, thisvalue was determined for patients with central vertigo as 6.0 + 6.0 mg/L. The averagefibrinogen level for the patients having peripheral vertigo was 411.8 + 173.5 mg/dl, andfor the patients having central vertigo was 473.5 + 184.6. For those three parameters, thedifference between them were not statistically important (p>0.05). When the Cut-offvalue for CRP was taken as 6mg/L; it was observed that, statistically, the number ofpatients whose CRP value were above this value was significantly higher than thenumber of patients having peripheral vertigo with CRP value being above this value(p>0.05).In differantial diagnosis of Vertigo, besides of historical past, clinical, physicaland neurological examination, many studies being carried out to find out the importanceof the use of certain serologic determinants. However, neither any clear result has beenobtained nor any specific determinants have been found yet. In our study too, it isconcluded that D-Dimer, fibrinogen and CRP cannot be regarded as the important andsignificant determinants of central or peripheral vertigo.2