Access the full text.
Sign up today, get DeepDyve free for 14 days.
ET Sert, S Cayir, H Mutlu, K Kokulu (2021)Effectiveness of clinical risk factors in the detection of central pathology in patients with isolated vertigo
M Tabuas‐Pereira, J Sargento‐Freitas, L Isidoro (2017)Neurosonology accuracy for isolated acute vestibular syndromes
JC Kattah, DE Newman‐Toker (2022)Video?oculography to guide neuroimaging for dizziness and vertigo
AA Tarnutzer, AL Berkowitz, KA Robinson, YH Hsieh, DE Newman‐Toker (2011)Does my dizzy patient have a stroke? A systematic review of bedside diagnosis in acute vestibular syndrome
BB Navi, H Kamel, MP Shah (2013)The use of neuroimaging studies and neurological consultation to evaluate dizzy patients in the emergency department
AE Quimby, ESH Kwok, D Lelli, P Johns, D Tse (2018)Usage of the HINTS exam and neuroimaging in the assessment of peripheral vertigo in the emergency department
C Gerlier, M Hoarau, A Fels (2021)Differentiating central from peripheral causes of acute vertigo in an emergency setting with the HINTS, STANDING, and ABCD2 tests: a diagnostic cohort study
DE Newman‐Toker, JC Kattah, JE Alvernia, DZ Wang (2008)Normal head impulse test differentiates acute cerebellar strokes from vestibular neuritis
MB Salmela, S Mortazavi (2017)ACR appropriateness criteria((R)) cerebrovascular disease
D Sankalia, S Kothari, DS Phalgune (2021)Diagnosing stroke in acute vertigo: sensitivity and specificity of HINTS battery in Indian population
ME Adams, P Karaca‐Mandic, S Marmor (2022)Use of neuroimaging for patients with dizziness who present to outpatient clinics vs emergency departments in the US
J Hanna, A Malhotra, PR Brauer, A Luryi, E Michaelides (2019)A comparison of benign positional vertigo and stroke patients presenting to the emergency department with vertigo or dizziness
HJ Schunemann, RA Mustafa, J Brozek (2020)GRADE guidelines: 21 part 1. Study design, risk of bias, and indirectness in rating the certainty across a body of evidence for test accuracy
Y Ozono, T Kitahara, M Fukushima (2014)Differential diagnosis of vertigo and dizziness in the emergency department
HJ Schunemann, RA Mustafa, J Brozek (2020)GRADE guidelines: 21 part 2. Test accuracy: inconsistency, imprecision, publication bias, and other domains for rating the certainty of evidence and presenting it in evidence profiles and summary of findings tables
B Machner, JH Choi, P Trillenberg (2020)Risk of acute brain lesions in dizzy patients presenting to the emergency room: who needs imaging and who does not?
BB Navi, H Kamel, MP Shah (2012)Rate and predictors of serious neurologic causes of dizziness in the Emergency Department
NM Finnerty, RM Rodriguez, CR Carpenter (2015)Clinical decision rules for diagnostic imaging in the emergency department: a research agenda
L Chen, W Lee, BR Chambers, HM Dewey (2011)Diagnostic accuracy of acute vestibular syndrome at the bedside in a stroke unit
AS Saber Tehrani, D Coughlan, YH Hsieh (2013)Rising annual costs of dizziness presentations to U.S. emergency departments
KA Kerber, DL Brown, LD Lisabeth, MA Smith, LB Morgenstern (2006)Stroke among patients with dizziness, vertigo, and imbalance in the emergency department: a population?based study
HK Kanzaria, AM McCabe, ZM Meisel (2015)Advancing patient?centered outcomes in emergency diagnostic imaging: a research agenda
AS Kim, S Sidney, JG Klingman, SC Johnston (2012)Practice variation in neuroimaging to evaluate dizziness in the ED
Z Karakaya, S Ozdinc, FE Topal, G Korol, A Capaci, PY Akyol (2017)Evaluation of the CCT and MRI results of patients hospitalized after applying to the emergency department with vertigo complaints
MV Kene, DW Ballard, DR Vinson, AS Rauchwerger, HR Iskin, AS Kim (2015)Emergency physician attitudes, preferences, and risk tolerance for stroke as a potential cause of dizziness symptoms
JA Edlow (2019)The timing?and?triggers approach to the patient with acute dizziness
CR Carpenter, AS Raja, MD Brown (2015)Overtesting and the downstream consequences of overtreatment: implications of "preventing overdiagnosis" for emergency medicine
D Pavlin‐Premrl, J Waterston, S McGuigan (2015)Importance of spontaneous nystagmus detection in the differential diagnosis of acute vertigo
JC Kattah, AV Talkad, DZ Wang, Y‐H Hsieh, DE Newman‐Toker (2009)HINTS to diagnose stroke in the acute vestibular syndrome: three?step bedside oculomotor examination more sensitive than early MRI diffusion?weighted imaging
J‐H Choi, M‐G Park, SY Choi (2017)Acute transient vestibular syndrome: prevalence of stroke and efficacy of bedside evaluation
KL Gurley, JA Edlow (2019)Acute dizziness
PF Whiting, AW Rutjes, ME Westwood (2011)QUADAS?2: a revised tool for the quality assessment of diagnostic accuracy studies
JA Edlow, KL Gurley, DE Newman‐Toker (2018)A new diagnostic approach to the adult patient with acute dizziness
H Ammar, R Govindu, R Fouda, W Zohdy, E Supsupin (2017)Dizziness in a community hospital: central neurological causes, clinical predictors, and diagnostic yield and cost of neuroimaging studies
A Guarnizo, K Farah, DA Lelli, D Tse, N Zakhari (2021)Limited usefulness of routine head and neck CT angiogram in the imaging assessment of dizziness in the emergency department
JA Edlow (2016)A new approach to the diagnosis of acute dizziness in adult patients
AS Saber Tehrani, JC Kattah, G Mantokoudis (2014)Small strokes causing severe vertigo: frequency of false?negative MRIs and nonlacunar mechanisms
P Neely, H Patel, T Wellings (2021)Benign paroxysmal positional vertigo in the emergency department: an observational study of an Australian regional hospital's acute clinical practice
SF Ahsan, MN Syamal, K Yaremchuk, E Peterson, M Seidman (2013)The costs and utility of imaging in evaluating dizzy patients in the emergency room
VN Nyaga, M Arbyn (2022)Metadta: a Stata command for meta?analysis and meta?regression of diagnostic test accuracy data ? a tutorial
P Nazerian, S Bigiarini, R Pecci (2018)Duplex sonography of vertebral arteries for evaluation of patients with acute vertigo
M Chase, NR Joyce, E Carney (2012)ED patients with vertigo: can we identify clinical factors associated with acute stroke?
MK Park, KM Kim, N Lee, HH Jung, SW Chae (2014)The usefulness of magnetic resonance imaging for acute isolated vertigo patients in the emergency department
JA Chalela, CS Kidwell, LM Nentwich (2007)Magnetic resonance imaging and computed tomography in emergency assessment of patients with suspected acute stroke: a prospective comparison
JR Marin, AM Mills (2015)Developing a research agenda to optimize diagnostic imaging in the emergency department: an executive summary of the 2015 academic emergency medicine consensus conference
DE Newman‐Toker, JA Edlow (2015)TiTrATE: a novel evidence?based approach to diagnosing acute dizziness and vertigo
HR Hixson, C Leiva‐Salinas, S Sumer, J Patrie, W Xin, M Wintermark (2016)Utilizing dual energy CT to improve CT diagnosis of posterior fossa ischemia
R Doijiri, H Uno, K Miyashita, M Ihara, K Nagatsuka (2016)How commonly is stroke found in patients with isolated vertigo or dizziness attack?
BACKGROUNDPatients presenting to the emergency department (ED) with symptoms of acute vertigo or dizziness represent a diagnostic challenge for the emergency physician.1 Physicians must distinguish the majority of patients who will have a benign or self‐limiting condition from those who might have a more serious cause for the symptoms. A good history and physical examination are the most important tools clinicians have available to risk stratify and narrow the differential diagnosis.2–7 Focus on the timing and the triggers of the symptoms has been proposed.8,9 The most common causes of vertigo include vestibular neuritis; labyrinthitis; benign paroxysmal positional vertigo (BPPV); acoustic neuroma; vestibular migraine; and less likely posterior circulation (vertebrobasilar) transient ischemic attack, ischemic stroke, or intracerebral hemorrhage.A minority of patients presenting with symptoms of acute vertigo might require neuroimaging. Currently, misdiagnoses are frequent and diagnostic testing costs are high.2,10,11 Unfortunately, clinicians overrely on the utility of noncontrast computed tomography (CT) of the head as well as in CT angiography (CTA) for these patients.12,13 Furthermore, the use of neuroimaging for ED patients with dizziness has not been associated with more stroke diagnoses.14 A study on commercial and Medicare Advantage claims for 800,000 adults with new diagnosis of dizziness found CT
Academic Emergency Medicine – Wiley
Published: May 1, 2023
Access the full text.
Sign up today, get DeepDyve free for 14 days.