Comparative study of clinical features and vascular risk factors in patients with unexplained non-acute dizziness and headache in cerebrovascular disease clinic_West China Medical Journal

Authors：

SONG Xindi , GUO Wen , LIU Meng , DENG Yilun , WU Qian , WANG Yanan , YE Kaili ,  LIU Ming

Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

LIU Ming, Email: liuming201502@163.com

Keywords：

Dizziness; unexplained; vascular risk factor; comparative study

DOI：

10.7507/1002-0179.202203104

Video：

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Objective To analyze the difference of clinical characteristics and vascular risk factors between patients with unexplained non-acute dizziness and headache, so that to bring new perspective on prevention of vascular risk factors and enhancement of symptoms among different patients. Methods The data of patients in the cerebrovascular disease clinic of the Department of Neurology, West China Hospital of Sichuan University between July 1th and September 30th, 2021 were collected retrospectively. The included patients were divided into dizziness group or headache group according to the complained. The clinical characteristics and risk factors of the two groups were compared. Results A total of 273 patients were included. There were 198 cases (72.5%) in dizziness group and 75 cases (27.5%) in headache group. Compared with headache group, patients in dizziness group were older, with a shorter course of disease, and accounted for a higher proportion of patients with symptoms related to body position, higher proportion of patients with hypertension and carotid plaque, and more vascular risk factors (P<0.05). Logistic regression results showed that patients with symptoms related to body position [odds ratio (OR)=7.025, 95% confidence interval (CI) (1.772, 28.488), P=0.007], at least one [OR=2.461, 95%CI (1.298, 4.664), P=0.006], two or more vascular risk factors [OR=2.314, 95%CI (1.033, 5.186), P=0.042] were independently associated with dizziness. The longer course of disease [OR=0.994, 95%CI (0.990, 0.997), P=0.001] was independently associated with headache. Conclusion Patients with non-acute unexplained dizziness and headache, especially those with dizziness, should pay more attention to the inquiry and treatment of vascular risk factors and psychopsychological factors.

Citation： SONG Xindi, GUO Wen, LIU Meng, DENG Yilun, WU Qian, WANG Yanan, YE Kaili, LIU Ming. Comparative study of clinical features and vascular risk factors in patients with unexplained non-acute dizziness and headache in cerebrovascular disease clinic. West China Medical Journal, 2022, 37(6): 844-849. doi: 10.7507/1002-0179.202203104 Copy

1.	Bronstein AM, Lempert T. Management of the patient with chronic dizziness. Restor Neurol Neurosci, 2010, 28(1): 83-90.
2.	Maarsingh OR, Dros J, Schellevis FG, et al. Causes of persistent dizziness in elderly patients in primary care. Ann Fam Med, 2010, 8(3): 196-205.
3.	朱燚, 周東. 門診頭痛患者 1700 例的臨床分析. 華西醫學, 2008, 23(3): 462-463.
4.	陶建青. 2061 例頭痛患者的病因分析. 山東醫藥, 2014, 54(12): 82-84.
5.	薛立伏, 馮瑩瑩, 韓玉晶, 等. 850 例門診頭痛患者的病因分析. 中西醫結合心腦血管病雜志, 2015, 13(10): 1233-1235.
6.	薛慧, 崇奕, 蔣子棟, 等. 神經內科眩暈/頭暈患者的病因分析. 中華醫學雜志, 2018, 98(16): 1227-1230.
7.	曹鵬禹, 劉紅巾, 徐先榮, 等. 門診主訴"眩暈或頭暈"患者病因分層分析. 聽力學及言語疾病雜志, 2020, 28(6): 631-635.
8.	王朝霞, 李遠軍, 徐先榮, 等. 眩暈中心門診 1419 例患者的病因分層研究. 中華臨床醫師雜志(電子版), 2018, 12(4): 218-222.
9.	Rego ?R, Dias D, Pinto A, et al. The cardiovascular aspects of a Ménière's disease population-a pilot study. J Otol, 2019, 14(2): 51-56.
10.	Minen MT, Weissman J, Tietjen GE. The relationship between migraine or severe headache and chronic health conditions: a cross-sectional study from the national health interview survey 2013-2015. Pain Med, 2019, 20(11): 2263-2271.
11.	Di Carlo A, Lamassa M, Baldereschi M, et al. Risk factors and outcome of subtypes of ischemic stroke. Data from a multicenter multinational hospital-based registry. The european community stroke project. J Neurol Sci, 2006, 244(1/2): 143-150.
12.	Wu B, Lin S, Hao Z, et al. Proportion, risk factors and outcome of lacunar infarction: a hospital-based study in a Chinese population. Cerebrovasc Dis, 2010, 29(2): 181-187.
13.	Alla S, Rao MY, Aslam SM. Clinical profiles of elderly patients presenting with persistent dizziness. J Natl Med Assoc, 2020, 112(4): 362-373.
14.	Do TP, la Cour Karottki NF, Ashina M. Updates in the diagnostic approach of headache. Curr Pain Headache Rep, 2021, 25(12): 80.
15.	Wang YF, Wang SJ. Hypertension and migraine: time to revisit the evidence. Curr Pain Headache Rep, 2021, 25(9): 58.
16.	Finocchi C, Sassos D. Headache and arterial hypertension. Neurol Sci, 2017, 38(Suppl 1): 67-72.
17.	Yilmaz Avci A, Akkucuk MH, Torun E, et al. Migraine and subclinical atherosclerosis: endothelial dysfunction biomarkers and carotid intima-media thickness: a case-control study. Neurol Sci, 2019, 40(4): 703-711.
18.	劉鳴, 劉峻峰, 吳波. 腦血管病分類分型進展與解讀. 中華神經科雜志, 2017, 50(3): 163-167.
19.	中華醫學會神經病學分會, 中華醫學會神經病學分會腦血管病學組. 中國腦血管疾病分類 2015. 中華神經科雜志, 2017, 50(3): 168-171.
20.	Lahmann C, Henningsen P, Brandt T, et al. Psychiatric comorbidity and psychosocial impairment among patients with vertigo and dizziness. J Neurol Neurosurg Psychiatry, 2015, 86(3): 302-308.
21.	Stubberud A, Buse DC, Kristoffersen ES, et al. Is there a causal relationship between stress and migraine? Current evidence and implications for management. J Headache Pain, 2021, 22(1): 155.
22.	代瑞紅, 廖曉陽. 失眠與緊張性頭痛及其誘因間關系的研究進展. 中國全科醫學, 2020, 23(36): 4615-4618.
23.	黃頤, 孫學禮. 心身障礙病因學理論研究進展. 華西醫學, 2005, 20(1): 162-163.
24.	O'Donnell MJ, Chin SL, Rangarajan S, et al. Global and regional effects of potentially modifiable risk factors associated with acute stroke in 32 countries (INTERSTROKE): a case-control study. Lancet, 2016, 388(10046): 761-775.
25.	Bassetti CLA, Randerath W, Vignatelli L, et al. EAN/ERS/ESO/ESRS statement on the impact of sleep disorders on risk and outcome of stroke. Eur J Neurol, 2020, 27(7): 1117-1136.
26.	Serrador JM, Hughson RL, Kowalchuk JM, et al. Cerebral blood flow during orthostasis: role of arterial CO₂. Am J Physiol Regul Integr Comp Physiol, 2006, 290(4): R1087-R1093.
27.	Sándor P. Nervous control of the cerebrovascular system: doubts and facts. Neurochem Int, 1999, 35(3): 237-259.
28.	Serrador JM, Shoemaker JK, Brown TE, et al. Cerebral vasoconstriction precedes orthostatic intolerance after parabolic flight. Brain Res Bull, 2000, 53(1): 113-120.
29.	Wilson TD, Serrador JM, Shoemaker JK. Head position modifies cerebrovascular response to orthostatic stress. Brain Res, 2003, 961(2): 261-268.
30.	Saavedra JM, Nishimura Y. Angiotensin and cerebral blood flow. Cell Mol Neurobiol, 1999, 19(5): 553-573.
31.	Zebenholzer K, Andree C, Lechner A, et al. Prevalence, management and burden of episodic and chronic headaches-a cross-sectional multicentre study in eight Austrian headache centres. J Headache Pain, 2015, 16: 531.

1. Bronstein AM, Lempert T. Management of the patient with chronic dizziness. Restor Neurol Neurosci, 2010, 28(1): 83-90.
2. Maarsingh OR, Dros J, Schellevis FG, et al. Causes of persistent dizziness in elderly patients in primary care. Ann Fam Med, 2010, 8(3): 196-205.
3. 朱燚, 周東. 門診頭痛患者 1700 例的臨床分析. 華西醫學, 2008, 23(3): 462-463.
4. 陶建青. 2061 例頭痛患者的病因分析. 山東醫藥, 2014, 54(12): 82-84.
5. 薛立伏, 馮瑩瑩, 韓玉晶, 等. 850 例門診頭痛患者的病因分析. 中西醫結合心腦血管病雜志, 2015, 13(10): 1233-1235.
6. 薛慧, 崇奕, 蔣子棟, 等. 神經內科眩暈/頭暈患者的病因分析. 中華醫學雜志, 2018, 98(16): 1227-1230.
7. 曹鵬禹, 劉紅巾, 徐先榮, 等. 門診主訴"眩暈或頭暈"患者病因分層分析. 聽力學及言語疾病雜志, 2020, 28(6): 631-635.
8. 王朝霞, 李遠軍, 徐先榮, 等. 眩暈中心門診 1419 例患者的病因分層研究. 中華臨床醫師雜志(電子版), 2018, 12(4): 218-222.
9. Rego ?R, Dias D, Pinto A, et al. The cardiovascular aspects of a Ménière's disease population-a pilot study. J Otol, 2019, 14(2): 51-56.
10. Minen MT, Weissman J, Tietjen GE. The relationship between migraine or severe headache and chronic health conditions: a cross-sectional study from the national health interview survey 2013-2015. Pain Med, 2019, 20(11): 2263-2271.
11. Di Carlo A, Lamassa M, Baldereschi M, et al. Risk factors and outcome of subtypes of ischemic stroke. Data from a multicenter multinational hospital-based registry. The european community stroke project. J Neurol Sci, 2006, 244(1/2): 143-150.
12. Wu B, Lin S, Hao Z, et al. Proportion, risk factors and outcome of lacunar infarction: a hospital-based study in a Chinese population. Cerebrovasc Dis, 2010, 29(2): 181-187.
13. Alla S, Rao MY, Aslam SM. Clinical profiles of elderly patients presenting with persistent dizziness. J Natl Med Assoc, 2020, 112(4): 362-373.
14. Do TP, la Cour Karottki NF, Ashina M. Updates in the diagnostic approach of headache. Curr Pain Headache Rep, 2021, 25(12): 80.
15. Wang YF, Wang SJ. Hypertension and migraine: time to revisit the evidence. Curr Pain Headache Rep, 2021, 25(9): 58.
16. Finocchi C, Sassos D. Headache and arterial hypertension. Neurol Sci, 2017, 38(Suppl 1): 67-72.
17. Yilmaz Avci A, Akkucuk MH, Torun E, et al. Migraine and subclinical atherosclerosis: endothelial dysfunction biomarkers and carotid intima-media thickness: a case-control study. Neurol Sci, 2019, 40(4): 703-711.
18. 劉鳴, 劉峻峰, 吳波. 腦血管病分類分型進展與解讀. 中華神經科雜志, 2017, 50(3): 163-167.
19. 中華醫學會神經病學分會, 中華醫學會神經病學分會腦血管病學組. 中國腦血管疾病分類 2015. 中華神經科雜志, 2017, 50(3): 168-171.
20. Lahmann C, Henningsen P, Brandt T, et al. Psychiatric comorbidity and psychosocial impairment among patients with vertigo and dizziness. J Neurol Neurosurg Psychiatry, 2015, 86(3): 302-308.
21. Stubberud A, Buse DC, Kristoffersen ES, et al. Is there a causal relationship between stress and migraine? Current evidence and implications for management. J Headache Pain, 2021, 22(1): 155.
22. 代瑞紅, 廖曉陽. 失眠與緊張性頭痛及其誘因間關系的研究進展. 中國全科醫學, 2020, 23(36): 4615-4618.
23. 黃頤, 孫學禮. 心身障礙病因學理論研究進展. 華西醫學, 2005, 20(1): 162-163.
24. O'Donnell MJ, Chin SL, Rangarajan S, et al. Global and regional effects of potentially modifiable risk factors associated with acute stroke in 32 countries (INTERSTROKE): a case-control study. Lancet, 2016, 388(10046): 761-775.
25. Bassetti CLA, Randerath W, Vignatelli L, et al. EAN/ERS/ESO/ESRS statement on the impact of sleep disorders on risk and outcome of stroke. Eur J Neurol, 2020, 27(7): 1117-1136.
26. Serrador JM, Hughson RL, Kowalchuk JM, et al. Cerebral blood flow during orthostasis: role of arterial CO₂. Am J Physiol Regul Integr Comp Physiol, 2006, 290(4): R1087-R1093.
27. Sándor P. Nervous control of the cerebrovascular system: doubts and facts. Neurochem Int, 1999, 35(3): 237-259.
28. Serrador JM, Shoemaker JK, Brown TE, et al. Cerebral vasoconstriction precedes orthostatic intolerance after parabolic flight. Brain Res Bull, 2000, 53(1): 113-120.
29. Wilson TD, Serrador JM, Shoemaker JK. Head position modifies cerebrovascular response to orthostatic stress. Brain Res, 2003, 961(2): 261-268.
30. Saavedra JM, Nishimura Y. Angiotensin and cerebral blood flow. Cell Mol Neurobiol, 1999, 19(5): 553-573.
31. Zebenholzer K, Andree C, Lechner A, et al. Prevalence, management and burden of episodic and chronic headaches-a cross-sectional multicentre study in eight Austrian headache centres. J Headache Pain, 2015, 16: 531.

West China Medical Journal

Comparative study of clinical features and vascular risk factors in patients with unexplained non-acute dizziness and headache in cerebrovascular disease clinic

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