It is an unreal spinning sensation of one's own body or surrounding objects, in the context of a disease that reduces the blood supply to an area of the brain (cerebral vascular accident).
The cause is a small embolus or blood clot that temporarily occludes the blood supply to the artery. It usually originates in the aorta or large vessels in the neck, and breaks up within 24 hours allowing arterial blood flow to resume.
Symptoms appear abruptly coinciding with the stop in blood flow, and disappear within minutes or hours as the clot breaks up (usually within 24 hours). The most common symptoms are headache, nausea, vomiting, inattention and memory loss.
It requires immediate treatment to prevent the formation of new clots and to remove those that have formed. Anti-aggregation drugs (aspirin, clopidogrel, etc.) and anticoagulants (warfarin, acenocoumarol, etc.) should be used. Cardiovascular risk factors must be suppressed to avoid recurrence.
- Joseph M Furman. Pathophysiology, etiology, and differential diagnosis of vertigo. UpToDate. jun 03, 2015.
- Lee CC, Su YC, Ho HC, et al. Risk of stroke in patients hospitalized for isolated vertigo: a four-year follow-up study. Stroke 2011; 42:48.
- Joseph M Furman, Jason JS Barton. Evaluation of the patient with vertigo. UpToDate. Jun 10, 2015.
- Kerber KA, Brown DL, Lisabeth LD, et al. Stroke among patients with dizziness, vertigo, and imbalance in the emergency department: a population-based study. Stroke 2006; 37:2484.
- Chacón-Martinez J, Jiménez-Antolín JA, Garrido-Robres JA. Mareos y vértigos en urgencias. Manual de protocolos y actuación en urgencias. Hospital Virgen de la Salud, Complejo Hospitalario de Toledo. Tercera edición. 2010: 545-552.
