Pitfalls and Rewards for Implementing Emergent Bedside Oculomotor Testing in Patients with Acute Vestibular Syndrome (.pdf)

Patients with Acute Vestibular Syndrome (AVS) commonly presents to the Emergency Department and pose management challenges given concerns for posterior fossa strokes. A three-step bedside oculomotor examination called HINTS Plus (Head-Impulse, Nystagmus, Test-of-Skew Plus acute hearing loss) was shown to accurately identify small infarcts as a cause of AVS. We studied the feasibility of implementing HINTS testing in the ED, aiming to reduce unnecessary neuroimaging and improve posterior circulation stroke detection.