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Many patients present to urgent care settings with vertigo, but identifying which patients require urgent evaluation is difficult. The HINTS examination (Stroke 2009; 40:3504) is used to distinguish central versus peripheral causes of vertigo, but it only applies to patients who present with acute vestibular syndromes (i.e., rapid onset of vertigo, nausea, vomiting, and unsteady gait), and it can be challenging to perform and interpret.
In this study from Canada, researchers derived a new risk score to predict which patients with vertigo are at high risk for a serious cause (i.e., stroke, transient ischemic attack, brain tumor, or vertebral artery dissection). They prospectively enrolled ≈2000 adults (mean age, 77) who presented to one of th…