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Journal of Neurology

, Volume 263, Issue 11, pp 2151–2157 | Cite as

Acute vestibular syndrome: a critical review and diagnostic algorithm concerning the clinical differentiation of peripheral versus central aetiologies in the emergency department

  • J. Venhovens
  • J. Meulstee
  • W. I. M. Verhagen
Review

Abstract

Almost 20 % of cerebral ischaemic strokes occur in the posterior circulation. Estimates are that 20 % of these patients present with isolated vertigo. In approximately one-sixth to one-third of these patients, this symptom is wrongly diagnosed to be peripheral vestibular in origin. As a result, these missed stroke patients are withheld from therapeutic and secondary prophylactic treatment, which may result in unnecessary morbidity and mortality. We therefore propose a diagnostic algorithm concerning the clinical differentiation of acute vestibular syndrome (AVS) patients based on a critical review of the available literature.

Keywords

Acute vestibular syndrome (AVS) HINTS Head impulse test (HIT) Vertigo Vertebrobasilar stroke 

Notes

Compliance with ethical standards

Conflicts of interest

None to be disclosed.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • J. Venhovens
    • 1
  • J. Meulstee
    • 2
  • W. I. M. Verhagen
    • 2
  1. 1.Department of Neurology and Clinical NeurophysiologyAlbert Schweitzer HospitalDordrechtThe Netherlands
  2. 2.Department of Neurology and Clinical NeurophysiologyCanisius Wilhelmina HospitalNijmegenThe Netherlands

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