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Professional paper - Review paper
Pristup bolesniku s akutnom perifernom vrtoglavicom
Medicina Fluminensis, 59 (2023), 1; 16-31. https://doi.org/10.21860/medflum2023_292446
Radobuljac, Katarina; Maržić, Diana; Čuš, Nina; Šepić, Tatjana; Vuletić, Vladimira

Institutional repository: Repository of the University of Rijeka, Faculty of Medicine

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Radobuljac, K., Maržić, D., Čuš, N., Šepić, T. & Vuletić, V. (2023). Pristup bolesniku s akutnom perifernom vrtoglavicom. Medicina Fluminensis, 59. (1), 16-31. doi: 10.21860/medflum2023_292446

Radobuljac, Katarina, et al. "Pristup bolesniku s akutnom perifernom vrtoglavicom." Medicina Fluminensis, vol. 59, no. 1, 2023, pp. 16-31. https://doi.org/10.21860/medflum2023_292446

Radobuljac, Katarina, Diana Maržić, Nina Čuš, Tatjana Šepić and Vladimira Vuletić. "Pristup bolesniku s akutnom perifernom vrtoglavicom." Medicina Fluminensis 59, no. 1 (2023): 16-31. https://doi.org/10.21860/medflum2023_292446

Radobuljac, K., et al. (2023) 'Pristup bolesniku s akutnom perifernom vrtoglavicom', Medicina Fluminensis, 59(1), pp. 16-31. doi: 10.21860/medflum2023_292446

Radobuljac K, Maržić D, Čuš N, Šepić T, Vuletić V. Pristup bolesniku s akutnom perifernom vrtoglavicom. Medicina Fluminensis [Internet]. 2023 [cited 2024 July 13];59(1):16-31. doi: 10.21860/medflum2023_292446

K. Radobuljac, D. Maržić, N. Čuš, T. Šepić and V. Vuletić, "Pristup bolesniku s akutnom perifernom vrtoglavicom", Medicina Fluminensis, vol. 59, no. 1, pp. 16-31, 2023. [Online]. Available at: https://urn.nsk.hr/urn:nbn:hr:184:817745. [Accessed: 13 July 2024]

Metadata
Title (croatian)Pristup bolesniku s akutnom perifernom vrtoglavicom
Title (english)The Approach to the Patient with Acute Peripheral Vertigo
AuthorKatarina Radobuljac
AuthorDiana Maržić
AuthorNina Čuš
AuthorTatjana Šepić
AuthorVladimira Vuletić
Author's institutionUniversity of Rijeka
Faculty of Medicine
(Department of Neurology)
Scientific / art field,
discipline and subdiscipline		BIOMEDICINE AND HEALTHCARE
Clinical Medical Sciences
Neurology
Abstract (croatian)
Vrtoglavica i omaglica jedni su od najčešćih razloga zbog kojih bolesnici traže liječničku pomoć te su uzrok otprilike 3,5 % svih posjeta hitnoj medicinskoj službi. Veoma je bitno prepoznati životno ugrožavajuće vrtoglavice, koje zahtijevaju neposredno zbrinjavanje, te ih razlikovati od „benignih“, samolimitirajućih stanja. Upravo stoga bolesnici s akutnom vrtoglavicom često predstavljaju dijagnostički i terapijski izazov nadležnom liječniku. Aktualan pristup bolesniku s akutnom vrtoglavicom ne uzima u obzir samo kvalitetu simptoma, već stavlja naglasak i na vrijeme nastanka tegoba, trajanje, provokacijske čimbenike, prateće simptome i informacije o potencijalnim prijašnjim epizodama. S obzirom na vrijeme trajanja simptoma i provokacijske čimbenike, akutne vrtoglavice možemo svrstati u tri skupine: akutni (jednokratni) vestibularni sindrom, spontani povratni vestibularni sindrom i izazvani povratni vestibularni sindrom. Akutni vestibularni sindrom (AVS) označava iznenadnu pojavu vrtoglavice koja traje dulje od 24 sata, povezan je s mučninom, povraćanjem, nestabilnošću i nistagmusom, a simptomi su dodatno pogoršani pokretima glave. Razni središnji i periferni uzroci mogu potaknuti nastanak AVS-a, od kojih su najčešći vestibularni neuronitis (VN) i moždani udar stražnje cirkulacije. Kao moćan alat za prepoznavanje perifernog vestibularnog sindroma i moždanog udara u literaturi se zadnjih godina zagovara HINTS (engl. Head Impulse, Nystagmus, Test of Skew) plus protokol. Najčešći uzroci perifernog vestibularnog sindroma su benigni paroksizmalni pozicijski vertigo (BPPV), vestibularni neuronitis i Ménièreova bolest. U ovom članku donosimo pregled novijih pristupa koji pomažu u lakšem i bržem razlikovanju „benignih“ od ugrožavajućih oblika vrtoglavica, suvremenog liječenja, kao i pregled najčešćih perifernih vrtoglavica.
Abstract (english)
Vertigo and dizziness are among the most common reasons for patients to seek medical help and approximately 3.5 % of all emergency department visits are related to them. The acutely dizzy patient can present a diagnostic and management dilemma for emergency departments and physicians in charge of those patients. Hence, it is of great importance to distinguish the life-threatening conditions, which require acute treatment, from “benign”, self-limiting conditions. While the traditional approach to dizziness relies on “symptom quality” or “type”, the new approach is based on symptom timing, triggers, duration, associated symptoms and patient history. Based on timing and triggers, this new approach divides patients into three key categories: acute vestibular syndrome, spontaneous episodic vestibular syndrome and triggered episodic vestibular syndrome. The acute vestibular syndrome (AVS) is defined as the acute onset of persistent dizziness associated with nausea or vomiting, gait instability, nystagmus, and head-motion intolerance lasting longer than 24 hours. AVS is provoked by a variety of central and peripheral causes, the most common of which are vestibular neuritis and acute stroke (posterior circulation). The HINTS (Head Impulse, Nystagmus, Test of Skew) plus protocol is a powerful tool for distinguishing a possible posterior stroke from peripheral vestibular dysfunction and it has been highly recommended recently. The most common causes of peripheral vertigo are benign paroxysmal positioning vertigo (BPPV), vestibular neuritis and Ménière’s disease. In this article we bring a review of new approaches to vertigo which contribute to faster and easier differentiation of benign and life-threatening conditions. A review of the most common types of peripheral vertigo is also included.
Keywords (croatian)
Keywords (english)
Languagecroatian
Languageenglish
Publication typeProfessional paper - Review paper
Publication statusPublished
Peer reviewPeer review
Publication versionPublished version
Journal titleMedicina Fluminensis
Numberingvol. 59, no. 1, pp. 16-31
p-ISSN1847-6864
e-ISSN1848-820X
DOIhttps://doi.org/10.21860/medflum2023_292446
URN:NBNurn:nbn:hr:184:817745
Publication2023
Document URLhttps://hrcak.srce.hr/292446
Type of resourceText
Access conditionsOpen access
Terms of useLicence Attribution 4.0 International (CC BY 4.0) icon
Created on2023-03-01 07:02:08