HINTS IN THE ER- case report
Vertigo is a false sense of motion of either the environment or self and is diagnosed in approximately half of the patients with dizziness. Acute spontaneous onset of vertigo is called acute vestibular neuritis (AVN). It is caused by peripheral lesion and requires symptomatic treatment. The symptoms of AVN can mimic a central pathology like cerebellar or brainstem infarction with no concomitant red-flag manifestation. Magnetic Resonance Neuroimaging with Diffusion-weighted imaging (MRI-DWI) as well as Computed Tomography (CT) scan delivers false negatives results what significantly delays stroke treatment. HINTS is an acronym for the battery of three bedside tests of ocular motor physiology. The method is more sensitive in diagnosing posterior circulation infarct than MRI-DWI with specificity -96 %. We present a case of a patient with vertigo who underwent two cranial CT scans and neurological examination. HINTS was worrisome. The brainstem infarct diagnosis was confirmed by MRI-DWI.