medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2025-303medsovet-9344Research ArticleНЕВРОЛОГИЯNEUROLOGYСосудистое головокружениеVascular dizzinesshttps://orcid.org/0000-0002-7465-0677ПизоваН. В.PizovaN. V.

Пизова Наталия Вячеславовна, д.м.н., профессор кафедры нервных болезней с медицинской генетикой и нейрохирургией

150000, Ярославль, ул. Революционная, д. 5

Nataliia V. Pizova, Dr. Sci. (Med.), Professor of the Department of Nervous Diseases with Medical Genetics and Neurosurgery

5, Revolutsionnaya St., Yaroslavl, 150000

pizova@yandex.ruhttps://orcid.org/0000-0002-0522-675XПизовА. В.PizovA. V.

Пизов Александр Витальевич, к.б.н., доцент кафедры методики преподавания естественно-математических дисциплин в начальной школе

150000, Ярославль, ул. Республиканская, д. 108/1

Aleksandr V. Pizov, Cand. Sci. (Biol.), Associate Professor of the Department of Methods of Teaching Natural Sciences and Mathematics in Primary Schools

5, Revolutsionnaya St., Yaroslavl, 150000

avpizov@yandex.ruЯрославский государственный медицинский университетРоссияYaroslavl State Medical UniversityRussian FederationЯрославский государственный педагогический университет имени К.Д. УшинскогоРоссияYaroslavl State Pedagogical University named after K.D. UshinskyRussian Federation20251009202519136168Copyright © Пизова Н.В., Пизов А.В., 20252025Пизова Н.В., Пизов А.В.Pizova N.V., Pizov A.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/9344

Головокружение является распространенным симптомом, который может быть вызван различными патофизиологическими механизмами и встречается при многих заболеваниях. Как правило, головокружение обусловлено доброкачественными причинами, но в некоторых случаях оно может указывать на наличие жизнеугрожающих заболеваний. В зависимости от течения выделяют острый, эпизодический и хронический вестибулярные синдромы. Цереброваскулярная патология может быть одной из причин вестибулярного головокружения. При этом преходящее изолированное головокружение является одним из наиболее распространенных предвестников транзиторной ишемической атаки в вертебробазилярном бассейне. Ишемический инсульт рассматривается как наиболее частая причина центрального острого вестибулярного синдрома. Инсульты, проявляющиеся вестибулярными симптомами, в большинстве случаев возникают при поражении ствола головного мозга или мозжечка, но могут наблюдаться и при поражении полушарий головного мозга. Церебральная болезнь мелких сосудов играет центральную роль в возникновении головокружения у пожилых людей. Выявление сосудистой причины у пациента с острым головокружением является сложной задачей, особенно при отсутствии сопутствующих неврологических симптомов. В последние годы было разработано несколько методов прикроватной диагностики, которые позволяют эффективно дифференцировать периферическое и центральное головокружение. Международное общество Барани разработало и опубликовало диагностические критерии сосудистого головокружения, согласно которым выделяют несколько типов сосудистого головокружения: достоверное острое продолжительное, вероятное острое продолжительное, транзиторное и острое головокружение в развитии, а также вероятное острое головокружение в развитии и вероятное транзиторное головокружение. Лечение головокружения включает фармакологические, физиотерапевтические, психотерапевтические/поведенческие и, реже, хирургические подходы. Часто применяют комбинацию различных методов. Выбор терапии определяется патофизиологией и этиологией головокружения.

Dizziness is a common symptom that can stem from a range of pathophysiological mechanisms and occurs in many diseases. While dizziness is usually due to benign causes, it can sometimes signal serious, life-threatening illnesses. Focusing on the time course enables symptoms to be categorized into acute vestibular syndrome, episodic vestibular syndrome and chronic vestibular syndrome. Cerebrovascular pathology can be a cause of vestibular dizziness. In this case, transient isolated dizziness is one of the most common precursors of a transient ischemic attack in the vertebrobasilar basin. Ischemic stroke is considered as the most common cause of central acute vestibular syndrome. Strokes manifested by vestibular symptoms frequently occur due to damage to the brainstem or cerebellum, but can also be observed due to damage to the cerebral hemispheres. Cerebral small vessel disease is a significant factor in the development of dizziness in the elderly. Discriminating vascular causes in patients with acute vertigo is challenging, especially when associated neurological symptoms are not evident. In recent years, several bedside diagnostic techniques have been developed to effectively differentiate between peripheral and central vertigo. Diagnostic criteria for vascular vertigo were established and published by the International Barany Society for the classification of vascular vertigo into several types: definite acute prolonged vascular dizziness, probable acute prolonged vascular dizziness, transient and acute dizziness in evolution, as well as probable acute dizziness in evolution and probable transient dizziness. For the treatment of dizziness, pharmacological, physiotherapeutic, psychotherapeutic/behavioural and, less frequently, surgical approaches may be considered. Combination of different methods is often used. The choice of therapy depends on the pathophysiology and etiology of dizziness.

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The authors declare that there are no conflicts of interest present.