ORIGINAL RESEARCH article
Front. Neurol.
Sec. Stroke
This article is part of the Research TopicPost-stroke Epilepsy: Risks, Prognosis, and PreventionView all 9 articles
Correlation between Vascular Stenosis Severity and Dizziness Symptoms and Neurological Prognosis in Elderly Patients with Acute Ischemic Stroke
Provisionally accepted
- Beijing Chuiyangliu hospital, Beijing, China
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Purpose: This study aimed to assess the links between stenosis severity, posterior circulation involvement, dizziness, and short-term neurological outcomes. Methods: A retrospective analysis was performed on 134 elderly patients with acute ischemic stroke admitted from January 2024 to May 2025. All patients underwent Computed Tomography Angiography (CTA) or MRA of the intracranial and extracranial arteries, including the common and internal carotid arteries, the middle cerebral artery, the vertebral artery (VA), and the basilar artery (BA). Stenosis of extracranial segments was measured with North American Symptomatic Carotid Endarterectomy Trial (NASCET) criteria, while intracranial segments were assessed using Warfarin–Aspirin Symptomatic Intracranial Disease Trial (WASID) standards. Patients were grouped by the most severely affected major supplying artery as mild (<50%), moderate (50%–69%), or severe (≥70% or occlusion) stenosis. A separate vertebrobasilar artery (VA/BA) stenosis group included individuals with ≥50% stenosis of the vertebral or BA, regardless of anterior circulation status. Collected data included baseline characteristics, dizziness occurrence, Dizziness Handicap Inventory (DHI) scores, admission National Institutes of Health Stroke Scale (NIHSS) scores, and 3-month modified Rankin Scale (mRS) scores. Univariate and multivariate logistic regression analyses were conducted to identify risk factors. Results: Dizziness occurred more often in the severe stenosis group and the VA/BA stenosis group (44.9% and 50.0%, P<0.01). Cerebellar and brainstem infarctions were more frequent in VA/BA stenosis (83.3%) and were also more common in the dizziness group (65.8% vs 19.8%). In multivariable models, VA/BA stenosis (OR=3.42, 95% CI: 1.28–9.13) and posterior circulation infarction (OR=4.51, 95% CI: 2.01–10.13) were independent correlates of dizziness. Severe stenosis (OR=4.96) and VA/BA stenosis (OR=3.18) were independently associated with 3-month functional dependence (mRS≥3). Higher admission NIHSS (OR=1.42) and age (OR=1.10) were also linked to poorer outcomes. Conclusion: Severe stenosis and VA/BA stenosis increased the risks of dizziness and 3-month functional dependence in elderly patients with acute ischemic stroke. Posterior circulation infarction strongly predicted dizziness. Careful vascular imaging assessment and attention to dizziness may help identify high-risk patients and improve clinical management.
Keywords: Acute ischemic stroke, Dizziness, elderly patients, prognosis, Vascular stenosis
Received: 23 Oct 2025; Accepted: 15 Dec 2025.
Copyright: © 2025 Huo, Liu, Li, Zhao and Song. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Junting Huo
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