HINTS to diagnose stroke in the acute vestibular syndrome: Three-step bedside oculomotor examination more sensitive than early MRI diffusion-weighted imaging

Jorge C. Kattah, Arun V. Talkad, David Z. Wang, Yu-Hsiang Hsieh, David E Newman-Toker

Research output: Contribution to journalArticle

Abstract

BACKGROUND AND PURPOSE-: Acute vestibular syndrome (AVS) is often due to vestibular neuritis but can result from vertebrobasilar strokes. Misdiagnosis of posterior fossa infarcts in emergency care settings is frequent. Bedside oculomotor findings may reliably identify stroke in AVS, but prospective studies have been lacking. METHODS-: The authors conducted a prospective, cross-sectional study at an academic hospital. Consecutive patients with AVS (vertigo, nystagmus, nausea/vomiting, head-motion intolerance, unsteady gait) with ≤1 stroke risk factor underwent structured examination, including horizontal head impulse test of vestibulo-ocular reflex function, observation of nystagmus in different gaze positions, and prism cross-cover test of ocular alignment. All underwent neuroimaging and admission (generally

Original languageEnglish (US)
Pages (from-to)3504-3510
Number of pages7
JournalStroke
Volume40
Issue number11
DOIs
StatePublished - Nov 2009

Fingerprint

Diffusion Magnetic Resonance Imaging
Stroke
Head Impulse Test
Vestibular Neuronitis
Neurologic Gait Disorders
Vestibulo-Ocular Reflex
Vertigo
Emergency Medical Services
Diagnostic Errors
Neuroimaging
Nausea
Vomiting
Cross-Sectional Studies
Head
Observation
Prospective Studies

Keywords

  • Cerebrovascular accident
  • Diagnosis
  • Neurologic examination
  • Sensitivity and specificity
  • Vertigo

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Clinical Neurology
  • Advanced and Specialized Nursing

Cite this

HINTS to diagnose stroke in the acute vestibular syndrome : Three-step bedside oculomotor examination more sensitive than early MRI diffusion-weighted imaging. / Kattah, Jorge C.; Talkad, Arun V.; Wang, David Z.; Hsieh, Yu-Hsiang; Newman-Toker, David E.

In: Stroke, Vol. 40, No. 11, 11.2009, p. 3504-3510.

Research output: Contribution to journalArticle

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