The Necessity of Vertebral Artery Doppler/USG Examination in Vertigo Patients

Introduction: Vertigo, characterized by a sensation of spinning or movement, presents as a common complaint in primary care, emergency departments, neurology, psychiatry, and otolaryngology clinics. Its diverse etiologies, including inner ear disorders and neurological conditions, pose diagnostic challenges. The diagnostic process typically involves a comprehensive neurological examination, but additional tests like vertebral artery Doppler examination may be necessary, particularly when vascular causes are suspected. However, the necessity of this examination remains unclear. In this retrospective study, we aimed to evaluate the necessity of vertebral artery Doppler/USG examination in patients presenting with vertigo. Methods: A cohort of 1021 patients attending a neurology outpatient clinic with complaints of dizziness/vertigo underwent comprehensive evaluation, including vertebral artery ultrasound/Doppler examination. Results: The study revealed that the majority of patients (about 90%) exhibited no evidence of significant vertebral artery atherosclerosis. However, hemodynamically significant vertebral artery pathology was observed in 5.1% of patients, predominantly among older male individuals with cardiovascular risk factors. Additionally, anatomical variations in vertebral artery anatomy were noted, highlighting the importance of considering vascular factors in vertigo evaluation. Conclusion: These findings underscore the importance of tailored diagnostic approaches and comprehensive assessment in patients with vertigo, emphasizing the role of vertebral artery Doppler examination, particularly in specific patient subgroups. Over 60-year-old patients with vertigo are likely to have hemodynamically important vertebral artery atherosclerotic lesions and clinicians should keep this information in mind during daily practice. Understanding the necessity of this adjunctive diagnostic tool can aid in timely diagnosis and management, potentially reducing healthcare costs and optimizing patient outcomes. However, this examination may not be necessary in 90% of vertigo patients.