CT Angiogram Helps to Predict Ischemic Stroke in Dizzy Patients, but NOT Better than the Clinical Examination (P3.084)

Background: Dizziness is described in a variety of conditions. The ability to differentiate symptoms due to ischemia is critical to determine appropriate work-up and management. The gold standard, MRI, is costly and not readily available at all institutions. Objective: We sought to determine if the presence of calcium within cervical and intracranial vessels on CTA could help to determine stroke risk in patients presenting to the Emergency Department (ED) with subjective dizziness. Design/Methods : Medical, imaging, and laboratory data were retrospectively collected for 642 patients presenting to the ED with dizziness over a one year period. CTAs were obtained for 57 patients deemed by the ED to be ‘high risk’. Imaging was reviewed for both the presence of any calcium, and calcium within specific vascular beds (eg., cavernous carotid). Multivariable logistic regression determined factors associated with ischemic stroke, while ROC analysis determined the added benefit of CTA in predicting ischemia. Results: Age and systolic blood pressure were higher in patients with ischemia compared to those without ischemia (p 0.05). Conclusions : In patients with subjective dizziness, stroke risk factors and focal exam findings predict acute ischemic stroke. Calcification on CTA is also predictive, but does not significantly improve sensitivity. Disclosure: Dr. Chen has nothing to disclose. Dr. Schneider has nothing to disclose. Dr. Marsh has nothing to disclose.