Clinical progress note: Diagnostic approach to dizziness and vertigo.

Dizziness is a common clinical presentation that incurs huge financial costs. It is frequently misdiagnosed due to a wide differential involving both benign (inner ear disease) and serious (stroke) disorders. Traditional frameworks that emphasize symptom quality (dizziness/lightheadedness/vertigo) lack diagnostic utility.

Intravenous thrombolysis in patients with acute dizziness or imbalance and suspected ischemic stroke-systematic review.

Background: Correct identification of those patients presenting with an acute vestibular syndrome (AVS) or an acute imbalance syndrome (AIS) that have underlying posterior-circulation stroke (PCS) and thus may benefit from revascularization (intravenous thrombolysis (IVT), endovascular therapy (EVT)) is important. Treatment guidelines for AVS/AIS patients are lacking. We reviewed the evidence on acute treatment strategies in AVS/AIS focusing on predictors for IVT/EVT and outcome.

Differentiating Vestibular Migraine and Posterior Circulation Transient Ischemic Attack in the Emergency Department: An Expert Practice Review.

Background: Vestibular migraine (VM) is a subset of migraine and, as its name suggests, presents with both migrainous and vestibular symptoms. However, a more worrisome diagnosis that can present with similar features is posterior circulation transient ischemic attack (pc-TIA) presenting as episodes of isolated dizziness.

Objectives: The purpose of this article is to introduce emergency physicians to the diagnostic features of VM focusing on epidemiological context, timing and quality of symptoms that help differentiate vestibular migraine from pc-TIA.

Reversible Cerebral Vasoconstriction Syndrome for the Internist-A Narrative Review.

Reversible cerebral vasoconstriction syndrome is a common, increasingly recognized cause of thunderclap headache. Most patients have some type of trigger that precedes the onset (e.g.

Misdiagnosis of Acute Headache: Mitigating Medico-legal Risks.

Headache is a common complaint of patients in the emergency department. The large majority of them have self-limited causes but some have life, limb, brain, or vision-threatening secondary causes. The job of the emergency physicians is to distinguish the 2 groups.