Diagnostyka zawrotów głowy w warunkach szpitalnego oddziału ratunkowego
Streszczenie
Diagnostyka zawrotów głowy, ze względu na mnogość przyczyn i ich trudne różnicowanie, jest istotnym wyzwaniem w codziennej pracy neurologa konsultującego chorych w ramach szpitalnego oddziału ratunkowego. W świetle aktualnej wiedzy dolegliwości, które wyznaczają klasyczne podejście diagnostyczne, pacjenci często podają w sposób zmienny i niewiarygodny. Stawia to pod znakiem zapytania dotychczasowy podział na zawroty układowe i nieukładowe. Wykazano, że zaburzenia uznawane do tej pory za sztandarowe dla obu grup mogą powodować zarówno jeden, jak i drugi typ dolegliwości. Opieranie się wyłączenie na subiektywnych objawach może prowadzić do pomyłek diagnostycznych. Na podstawie przeglądu aktualnego piśmiennictwa przedstawiono inne podejście do różnicowania zawrotów głowy. Oparto je na wiarygodnych danych dostępnych w badaniu podmiotowym — zmienności objawów w czasie i czynnikach prowokujących. W ten sposób wyróżnia się kilka grup klasyfikacyjnych, w ramach których stosuje się celowane badania dodatkowe pozwalające ustalić ostateczne rozpoznanie.
Słowa kluczowe: zawroty głowyostry zespół przedsionkowyudar niedokrwienny mózguzapalenie nerwu przedsionkowego
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