Periferik Vertigoya Klinik Yaklaşım
Özet
Dengeyi sağlayan vestibüler sistemdeki patolojiler baş dönmesi, bulantı ve dengesizliğe yol açar. Anamnez aşamasında hastanın semptomları; spesifik olmayan sersemlik, pre-senkop, dengesizlik ve gerçek vertigo olarak dört grupta değerlendirilir. Periferik vertigo genellikle ani başlangıçlı, geçici ve baş hareketiyle tetiklenen niteliktedir. Buna karşın santral vertigo daha kademeli başlar, sürekli olabilir ve ek nörolojik bulgularla seyredebilir. Tanıda HINTS protokolü (Baş Savurma Testi, Nistagmus muayenesi ve Skew Deviasyon) ile Frenzel gözlüğü, okulomotor testler ve yürüme testleri gibi yatak başı muayeneler kritik rol oynar. HINTS incelemesi, akut vakalarda santral patolojileri saptamada erken dönem görüntüleme yöntemlerinden bile daha duyarlıdır.
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