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  • ISSN: 2476-2016
    Early Online
    Volume 3, Issue 3
    Case Report
    Eve Merry, Bhavini Patel, Joe J Leyon, and Kuven K Moodley*
    The acute vestibular syndrome is characterized by the abrupt or acute-onset of dizziness or vertigo, classically regarded in terms of peripheral and central (CNS) causes. Specifically, being able to accurately differentiate between posterior circulation stroke and acute vestibular disease is an all too common scenario facing emergency room and acute physicians alike. The consequences of misdiagnosis can be dire, particularly if the assessing clinician has not taken into account all aspects of the presenting history or performed an adequate clinical assessment. The limitations of acute CT scanning in this scenario must be appreciated, given that it has less predictive value than an adequate clinical assessment that incorporates the HINTS paradigm. We present a case of vertebral artery dissection, initially misattributed to vestibular neuronitis, complicated by arterial thrombus, stuttering posterior circulation ischemia and worsening disability. We use the case to illustrate how a targeted history and examination can be used to complement each other in recognizing acute posterior circulation strokes presenting with acute vestibular symptoms.
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