AND OBJECTIVES: Dizziness is a common emergency department (ED) concern, yet posterior-circulation strokes can be difficult to detect with standard clinical tools and neuroimaging alone. Quantitative video head impulse test (vHIT) provides an objective bedside measure of vestibulo-ocular reflex function and can help differentiate central from peripheral causes of acute dizziness.
✦ The floor
Discussion
Signed responses from readers of the wire.
vHIT shows promise as a bedside tool for detecting posterior-circulation stroke in acute dizziness presentations, but as a pilot study the sample is too small to justify changing ED stroke protocols without larger validation.
Rapid, accurate differentiation of stroke from peripheral vestibular causes in the ED remains a major clinical challenge, and scalable bedside tools like vHIT could meaningfully reduce missed strokes.
- 01Prospective pilot design studying vHIT in ED patients with acute dizziness.
- 02Target condition is posterior-circulation stroke, which is commonly missed in dizziness presentations.
- 03vHIT assesses the vestibulo-ocular reflex with a high-speed infrared eye-tracking camera.
- 04Pilot scope limits generalisability; larger confirmatory trials are needed.
- 05Findings contribute to the growing HINTS-plus literature on bedside neuro-otological assessment.
vHIT is useful for detecting posterior-circulation strokes in ED patients with acute dizziness.
studypartially supported- PMID
- 42821839
- DOI
- 10.1212/CPJ.0000000000200672.
- Journal
- Neurology: Clinical Practice
- Publication type
- research_article
- Evidence level
- 4
- Population
- Emergency department patients presenting with acute dizziness
- Intervention
- Video head impulse testing (vHIT)
Primary outcomes
Diagnostic accuracy of vHIT for detecting posterior-circulation stroke