Transient ischemic attack in the vertebrobasilar vascular territory as a cause of isolated vertigo

Abstract

Transient ischemic attack (TIA) in the vertebrobasilar vascular territory (VB) causes difficulties in diagnosis when it manifests only with vestibular symptoms. Issues relating to the differential diagnosis of TIA are discussed, awareness of which is necessary for the selection of informative methods of examination and the prescription of effective stroke prevention in patients with an episode of isolated dizziness. The likelihood of TIA as the cause of dizziness is increased by the patients' high cardiovascular risk, the presence of atrial fibrillation, severe instability during an attack, and head and/or neck pain. If a TIA in VB is suspected, it is advisable to perform a minimal instrumental examination, including computed tomography (CT) of the brain and CT angiography or diffusion-weighted magnetic resonance imaging (MRI) and MRI angiography. In case of doubt, additional information can be obtained by a perfusion CT or MRI as well as a post-contrast MRI. When interpreting the results of these methods of examination, their limitations in terms of application time and resolution should be taken into account.