Morrow, Stacy;
Koohi, Nehzat;
Kaski, Diego;
(2023)
Hyperacute assessment of vertigo in suspected stroke.
Frontiers in Stroke
, 2
, Article 1267251. 10.3389/fstro.2023.1267251.
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Abstract
The management of patients with acute vertigo is most challenging in the hyperacute phase, both due to the complexity of vertigo as a symptom, the range of possible causes, and the lack of training in neuro-otology for non-specialists. Perhaps of greatest relevance is differentiating between peripheral (usually benign, e.g., inner ear) causes and central (potentially more sinister, e.g., stroke) causes. Several diagnostic algorithms have been introduced to help detect stroke in patients with acute vertigo. However, these algorithms have been largely validated in patients with an acute vestibular syndrome (with nystagmus) for whom symptoms have been present for a minimum of 24 h. The most challenging period within the diagnostic process is the hyperacute phase that determines triage and treatment, but where none of the established algorithms have been validated. In this review, we specifically describe practical implementation considerations for evaluating patients with hyperacute vertigo, including the timing of diagnostic testing within the emergency department pathway, resource availability, and pitfalls associated with current practices.
| Type: | Article |
|---|---|
| Title: | Hyperacute assessment of vertigo in suspected stroke |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.3389/fstro.2023.1267251 |
| Publisher version: | https://doi.org/10.3389/fstro.2023.1267251 |
| Language: | English |
| Additional information: | © 2023 Morrow, Koohi and Kaski. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
| Keywords: | Hyperacute, vertigo, stroke, dizziness, education, assessments, telemedicine, HINTS |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Clinical and Movement Neurosciences |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10188761 |
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