malities had more stroke risk factors (≥3) than patients
with normal VA. The results of Chang et al. study
essentially paralleled these previous studies, i.e. patients
with isolated dizziness/vertigo of presumably vascular
origin were older, had higher body mass index (BMI),
metabolic derangement, and more stroke risk factors.
The most frequent sites of pathology in patients with
isolated dizziness/vertigo are brainstem and/or cerebel-
lum. Yamasoba et al. reported on a high prevalence of
lacunar infarcts in the hindbrain in aged patients with
. Chan et al. reported on a case of
pontine infarction due to VA thrombosis presenting with
chronic isolated vertigo
. Colledge et al. found more
white matter lesions especially in the midbrain in aged
dizzy patients (≥ 65) compared to control subjects
These authors postulated that cerebral small vessel dis-
ease could cause dizziness in susceptible patients. The
underlying mechanism of higher frequency of
leukoaraiosis in Chang et al. study
might be the same.
Given the high prevalence of isolated dizziness/ver-
tigo in our everyday practice, additional researches are
warranted to further delineate the role of vascular risk
factors and cerebral small vessel disease in these
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Acta Neurologica Taiwanica Vol 20 No 2 June 2011