Anatomy, physiology and clinical role of the vestibular cortex. The vestibular system, thanks to its peripheral organs, allows us to properly process the angular head movements and linear acceleration in order to give us a proper orientation in space. The information from these sensory inputs is routed to the vestibular nuclei and thence ascending tracts of the brainstem, which communicate with the oculomotor nuclei of the thalamus and structures. Then the information goes to subcortical and cortical centers, which are eminently multisensory nature.
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Introduction: One of the most important dilemmas concerning vertigo in emergency departments is its differential diagnosis. There are highly sensitive warning signs in the examination that can put us on the path towards finding ourselves before a case of central vertigo.
Aim: To determine how effective the application of the HINTS protocol is in the diagnosis of cerebrovascular accidents that mimics peripheral vertigo. Patients and methods: We conducted a descriptive observation-based study on patients admitted to hospital with a diagnosis of acute vestibular syndrome in the emergency department.
All the patients were monitored on a day-to-day basis until their symptoms improved, with information about nystagmus, the oculocephalic manoeuvre and the skew test. The results from the magnetic resonance imaging study were compared with the alteration of any of those three signs during the time the patient was hospitalised. Results: Altogether 91 patients were examined, with a mean age of A cerebrovascular accident was observed in eight cases.
Of these mean age: 71 years , in seven of them there were alterations in some of the HINTS signs, and in one case the study was normal sensitivity: 0. All of them had some vascular risk factor. Conclusions: Faced with a patient who visits the emergency department with an acute vestibular syndrome, a suitably directed examination is essential to be able to establish the differential diagnosis between peripheral and central pathology, since some cerebrovascular accidents can present with the appearance of acute vertigo.
Applying a protocol like HINTS makes it possible to suspect the central pathology with a high degree of sensitivity and specificity. Title: Vertigo periferico frente a vertigo central. Uno de los dilemas mas importantes concernientes al vertigo en urgencias es su diagnostico diferencial.
Existen signos de alarma de gran sensibilidad en la exploracion que pueden ponernos en la pista de encontrarnos ante un vertigo central. Determinar la eficacia de la aplicacion del protocolo HINTS en el diagnostico del accidente cerebrovascular que simula un vertigo periferico.
Pacientes y metodos. Estudio observacional descriptivo sobre pacientes ingresados con diagnostico de sindrome vestibular agudo en urgencias. Todos los pacientes fueron objeto de un seguimiento diario hasta la mejoria de sus sintomas con informacion del nistagmo, la maniobra de impulso oculocefalico y el test de skew. Se comparan los resultados del estudio de resonancia magnetica con la alteracion en alguno de esos tres signos a lo largo del ingreso del enfermo.
Se objetivo un accidente cerebrovascular en ocho de ellos. Todos ellos tenian algun factor de riesgo vascular. Una exploracion adecuada y dirigida ante un paciente que acude a urgencias con un sindrome vestibular agudo resulta de vital importancia para establecer el diagnostico diferencial entre la patologia periferica y la central, ya que algunos accidentes cerebrovasculares se pueden presentar bajo la apariencia de un vertigo agudo. Aplicar un protocolo como HINTS permite sospechar la patologia central con una gran sensibilidad y especificidad.
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Send even when there aren't any new results. Optional text in email:. Save Cancel. Create a file for external citation management software Create file Cancel. Full-text links Cite Favorites. Abstract in English , Spanish. Newman-Toker DE, et al. Acad Emerg Med. PMID: Importance of spontaneous nystagmus detection in the differential diagnosis of acute vertigo.
Pavlin-Premrl D, et al. J Clin Neurosci. Epub Dec Quantitative video-oculography to help diagnose stroke in acute vertigo and dizziness: toward an ECG for the eyes. Epub Mar 5. Acute vertigo due to hemispheric stroke: a case report and comprehensive review of the literature. J Neurol Sci. Epub Feb PMID: Review. The bedside assessment of vertigo. Kaski D, Seemungal BM.
Kaski D, et al. Clin Med Lond. No abstract available. Show more similar articles See all similar articles. Cited by 5 articles Value of copeptin and the Sb protein assay in ruling out the diagnosis of stroke-induced dizziness pattern in emergency departments. Deboevere N, et al. Clinical Trial. An Overview. Kattah JC. Stroke Vasc Neurol. Relapsing Ipsilateral Vestibular Neuritis. Emiliano De Schutter D, et al.
Case Rep Otolaryngol. Epub Dec 4. Han WG, et al. J Audiol Otol. Epub Sep 1. Carmona S, et al. Front Neurol. Publication types English Abstract Actions. Observational Study Actions. MeSH terms Aged Actions.
Aged, 80 and over Actions. Clinical Protocols Actions. Diagnosis, Differential Actions. Emergencies Actions. Female Actions. Humans Actions. Male Actions. Middle Aged Actions. Reflex, Abnormal Actions.
Vértigo periférico frente a vértigo central. Aplicación del protocolo HINTS
Introduction: One of the most important dilemmas concerning vertigo in emergency departments is its differential diagnosis. There are highly sensitive warning signs in the examination that can put us on the path towards finding ourselves before a case of central vertigo. Aim: To determine how effective the application of the HINTS protocol is in the diagnosis of cerebrovascular accidents that mimics peripheral vertigo. Patients and methods: We conducted a descriptive observation-based study on patients admitted to hospital with a diagnosis of acute vestibular syndrome in the emergency department. All the patients were monitored on a day-to-day basis until their symptoms improved, with information about nystagmus, the oculocephalic manoeuvre and the skew test.
[Peripheral Vertigo Versus Central Vertigo. Application of the HINTS Protocol]
Arroyo-Domingo , J. Marco-Algarra , M. Tabla I. Diferencia entre grupos a. Tabla II. Tabla III. Tabla IV.