C-reactive protein-to-albumin ratio and systemic immune-inflammatory index as potential markers in distinguishing acute cerebellar infarction from benign paroxysmal positional vertigo.

Objectives: To investigate the potential utility of the C-reactive protein-to-albumin ratio (CAR) and the systemic immune-inflammatory index (SII) as a biomarker in distinguishing between BPPV and acute cerebellar infarction (ACI) due to posterior inferior cerebellar artery (PICA) involvement.

Methods: The data of 2545 patients registered in our hospital database between 2017 and 2024 with a diagnosis of vertigo were retrospectively analyzed and 102 patients with benign paroxysmal positional vertigo (BPPV) and 100 patients with ACI were included in the study. Mann-Whitney U test, Chi-square test, or Fisher's exact test were used to compare variables between the two groups. Receiver operating characteristic (ROC) curve analysis was performed to investigate the predictive value of the data.

Results: The CAR and SII values were significantly higher in the ACI group compared to the BPPV group (<0.001, <0.001, respectively). The areas under the ROC curve (AUC) were as follows: CAR=0.768 (95% CI, 0.705-0.832), white blood cell count (WBC)=0.735 (95% CI, 0.667-0.802), monocytes=0.622 (95% CI, 0.544-0.699), red cell distribution width-standard deviation (RDW-SD)=0.600 (95% CI, 0.522-0.678), SII=0.674 (95% CI, 0.599-0.748), and neutrophil-to-lymphocyte ratio (NLR)=0.687 (95% CI, 0.613-0.761).

Conclusion: CAR and SII could be useful biomarkers to differentiate between ACI and BPPV in vertigo patients, but further validation is needed in larger studies.