Evaluating the morphological changes of intracranial arteries and whole-brain perfusion in undetermined isolated vertigo

PURPOSE: To determine the morphological changes of intracranial arteries and whole-brain perfusion in undetermined isolated vertigo (UIV) patients using 320-detector row computed tomography (CT). METHODS: A total of 150 patients who underwent CT angiography (CTA) and CT perfusion (CTP) imaging were divided into UIV group and benign paroxysmal positional vertigo (BPPV) group. Sixty individuals with sex- and age-matched without vertigo and cerebral diseases served as the control. The morphological changes of intracranial arteries, perfusion parameters and vascular risk factors (VRFs) were analyzed, calculated and compared. RESULTS: In UIV patients, hypertension (HT), hyperlipidemia and number of VRFs ≥ 3 occurred more commonly (P < 0.0125, respectively). The incidence of vertebral artery dominance (VAD), vertebral artery stenosis (VAS) and basilar artery curvature (BAC) were significantly higher (P < 0.0125, respectively). HT was an independent risk predictor of non-VAD (OR: 5.411, 95%CI: 1.401; 20.900, P = 0.014). HT and VAD associated with BAC served as risk predictors (OR: 4.081, 95%CI: 1.056;15.775, P = 0.041 and OR: 6.284, 95%CI: 1.848; 21.365, P = 0.003, respectively). The absolute difference in relative values of CTP parameters from cerebellum and brainstem were significantly different (P < 0.05), and hypoperfusion was found in the territories of the non-VAD side and the BAC cohort (P < 0.05, respectively). CONCLUSIONS: On the basis of multiple VRFs, morphological changes of vertebrobasilar artery (VBA) and the unilateral hypoperfusion of the cerebellum and brainstem, that acts as a herald for IV occurrence, which should be paid cautious attention to UIV patients.