{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T06:15:49Z","timestamp":1773036949525,"version":"3.50.1"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T00:00:00Z","timestamp":1773014400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"\n Background<\/jats:title>\n Distinguishing ischemic stroke in patients presenting with isolated dizziness or vertigo (IDV) from more benign causes remains a significant clinical challenge. Current understanding of the specific clinical and imaging characteristics that differentiate IDV strokes from strokes with non-isolated symptoms (NIDV) is incomplete.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study aimed to systematically compare the clinical characteristics, with a specific focus on infarction topography and lipid profiles, between patients with acute cerebral infarction presenting with IDV and those with NIDV.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n In this retrospective cohort study, we analyzed 136 patients with Magnetic Resonance Imaging (MRI)-confirmed acute cerebral infarction who presented with dizziness\/vertigo. Patients were classified into IDV (\n n<\/jats:italic>\n \u202f=\u202f53; NIHSS\u202f=\u202f0, no focal deficits) and NIDV (\n n<\/jats:italic>\n \u202f=\u202f83; NIHSS&gt;0 or focal deficits) groups based on a standardized neurological assessment. A comprehensive comparison of clinical characteristics was performed, including demographics, vascular risk factors, fasting lipid profiles, and neuroimaging features. Differences between groups were assessed using univariate analyses (Student\u2019s\n t<\/jats:italic>\n -tests, Chi-square tests, etc.), with variables significant at\n p<\/jats:italic>\n \u202f&lt;\u202f0.10 eligible for inclusion in a multivariate logistic regression model to identify factors independently associated with the stroke phenotype (IDV vs. NIDV).\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Univariate analysis revealed that the primary differences between groups lay in infarction topography and lipid profiles. Specifically, infarctions in the cerebellar hemisphere (47.2% vs. 25.3%;\n p<\/jats:italic>\n \u202f=\u202f0.009) and other cerebellar regions (18.9% vs. 4.8%;\n p<\/jats:italic>\n \u202f=\u202f0.009) were significantly more prevalent in the IDV group, whereas pontine infarctions were strongly associated with the NIDV group (13.2% vs. 41.0%;\n p<\/jats:italic>\n \u202f=\u202f0.001). Concurrently, the IDV group exhibited a more atherogenic lipid profile, with significantly higher levels of low-density lipoprotein cholesterol (LDL-C) (3.07\u202f\u00b1\u202f0.89 vs. 2.71\u202f\u00b1\u202f0.75\u202fmmol\/L,\n p<\/jats:italic>\n \u202f=\u202f0.013). Notably, the prevalence of acute lacunar infarcts was also higher in the IDV group (17.0% vs. 4.8%,\n p<\/jats:italic>\n \u202f=\u202f0.019). A history of hypertension was less prevalent in the IDV group (60.4% vs. 83.1%,\n p<\/jats:italic>\n \u202f=\u202f0.003), though this association was attenuated in the multivariate model (\n p<\/jats:italic>\n \u202f=\u202f0.052). In the multivariate model, pontine infarction remained a strong negative predictor of the IDV phenotype (adjusted OR\u202f=\u202f0.30,\n p<\/jats:italic>\n \u202f=\u202f0.016), while a higher LDL-C level emerged as an independent positive predictor (adjusted OR\u202f=\u202f1.67 per mmol\/L,\n p<\/jats:italic>\n \u202f=\u202f0.036).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n In patients with confirmed acute cerebral infarction, those presenting with isolated dizziness\/vertigo (IDV) represent a distinct phenotype characterized by a predisposition to cerebellar infarctions and a higher atherogenic lipid burden, specifically elevated LDL-C. These findings challenge the notion of a benign underlying vasculopathy in IDV stroke and underscore the necessity of comprehensive vascular assessment, including lipid profiling, in this patient population.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fneur.2026.1747076","type":"journal-article","created":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T05:22:55Z","timestamp":1773033775000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Distinct phenotype of isolated dizziness stroke: association with cerebellar infarctions and elevated LDL-C"],"prefix":"10.3389","volume":"17","author":[{"given":"Bing","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Neurology, Shijiazhuang People\u2019s Hospital","place":["Shijiazhuang, Hebei, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaopeng","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The Second Hospital of Hebei Medical University","place":["Shijiazhuang, Hebei, China"]},{"name":"Key Laboratory of Clinical Neurology, Ministry of Education, Hebei Medical University","place":["Shijiazhuang, Hebei, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaohui","family":"Su","sequence":"additional","affiliation":[{"name":"Department of Neurology, Shijiazhuang People\u2019s Hospital","place":["Shijiazhuang, Hebei, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lifang","family":"Chu","sequence":"additional","affiliation":[{"name":"Department of Neurology, Shijiazhuang People\u2019s Hospital","place":["Shijiazhuang, Hebei, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hui","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Shijiazhuang People\u2019s Hospital","place":["Shijiazhuang, Hebei, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Limin","family":"Nie","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Shijiazhuang People\u2019s Hospital","place":["Shijiazhuang, Hebei, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shujing","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Shijiazhuang People\u2019s Hospital","place":["Shijiazhuang, Hebei, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,9]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"788","DOI":"10.1161\/STROKEAHA.117.016979","article-title":"Diagnosing stroke in acute dizziness and vertigo: pitfalls and pearls","volume":"49","author":"Saber Tehrani","year":"2018","journal-title":"Stroke"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1002\/ana.24532","article-title":"Missed stroke 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