# Vascular vertigo and dizziness: managing and treating outpatients

## TL;DR

This study explores how antiplatelet and anticoagulant therapies help manage vascular vertigo and dizziness in outpatients, showing they reduce symptoms and prevent strokes.

## Contribution

The study provides real-world evidence for managing vascular vertigo using updated stroke guidelines and reports treatment outcomes in outpatients.

## Key findings

- 95.2% of patients experienced no new crises after treatment.
- Transient ischemic attack patients showed reduced imbalance discomfort.
- Dual and single antiplatelet therapies were most commonly used.

## Abstract

•Imbalance can be the main ischemic symptom on posterior circulation.•Vascular vertigo or dizziness are associated to stroke and transient attacks.•Antiplatelets are an important tool for treating vascular vertigo/dizziness.•Dual antiplatelet therapy can be used in selected patients.•Besides prevention, antiplatelets reduce the number of vertigo attacks.

Imbalance can be the main ischemic symptom on posterior circulation.

Vascular vertigo or dizziness are associated to stroke and transient attacks.

Antiplatelets are an important tool for treating vascular vertigo/dizziness.

Dual antiplatelet therapy can be used in selected patients.

Besides prevention, antiplatelets reduce the number of vertigo attacks.

Due the lack of data on the treatment of Vascular Vertigo and Dizziness, this study aimed to report how we managed and treated those outpatients according to the recently introduced American Heart Association and Stroke Association guidelines.

We conducted a longitudinal case series from May 2022 to February 2023. We included patients who met the Bárány Society’s Vascular Vertigo and Dizziness classification and were eligible for therapy in accordance with the American Heart Association and Stroke Association guidelines, featuring aspects of the stroke group and transient attack group.

Overall, 41 patients (51.2% female; median age 72 years) were enrolled; 10 (24.3%) had ischemic strokes, 30 (73.1%) had transient ischemic attack, and 1 (2.4%) had a probable isolated labyrinthine infarction. The patients received dual antiplatelet (48.7%), single antiplatelet therapy (48.7%), and anticoagulant therapy (2.4%). No new crises occurred in 95.2% of the patients, and the transient ischemic attack group showed a significant decrease in discomfort from imbalance on the visual analog scale.

Antiplatelets and anticoagulants are safe and effective in treating Vascular Vertigo and Dizziness as they prevent new ischemic events and increase the flow of the posterior circulation, reducing vertigo/dizziness attacks and imbalance complaints.

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