Importance of complete blood count parameters and neutrophil-to-lymphocyte ratio in central and peripheral vertigo

Vertigo is a common cause of admission to health centers, from family health centers to emergency departments (EDs) (1). It is classified into two main groups according to its underlying factors: central vertigo (CV) and peripheral vertigo (PV). Differentiation between CV and PV requires clinical and laboratory examinations of acute cardiac, metabolic, toxic, local, and systemic infection and exclusion of ischemic and hemorrhagic disorders related to the central nervous system. The importance of physical examinations alone in the diagnosis of patients with acute vestibular syndrome is well known in EDs and is tested using head impulse, nystagmus, and test of skew (HINTS), which is a three-step examination (2). HINTS was shown to be more useful than magnetic resonance diffusionweighted imaging (DWI) for differentiating between CV and PV. However, ED physicians may prefer to employ a brain computed tomography (CT) scan and/or DWI if there is suspicion of a central event related to ischemia or bleeding in the posterior fossa structures in vertigo patients (3). Acute ischemic stroke (AIS) is a type of brain injury that develops as a result of thrombotic or embolic occlusion of the brain’s blood flow and is affected by inflammatory processes (4). Complete blood count (CBC) parameters and the proportional values obtained from these parameters were reported to have diagnostic values as biomarkers (5-8). From the perspective of an ED physician, tests such as a CBC are simply components of routine practice and often have no direct impact on ED applications or diagnostic/prognostic value (9). Furthermore, the combined assessment of all laboratory results and clinical findings lead to preference for expensive, often unnecessary, central imaging methods. The present study investigated the role of CBC parameters and neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and mean platelet volume-to-MPV/PLT) ratio, which DOI: 10.4274/gulhane.galenos.2019.817 ORIGINAL ARTICLE