ReviewSeminars in neurology2015
Diagnosing Stroke in Acute Vertigo: The HINTS Family of Eye Movement Tests and the Future of the "Eye ECG".
Review in Seminars in neurology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 59 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
59 citing papers in PubMed, 3 syntheses or guidelines pooled it, 138 citations in OpenAlex.
- HINTS+ to diagnose AICA stroke: systematic review of the diagnostic impact of acute unilateral hearing loss in the acute vestibular syndrome.Journal of neurology · 2026Pooled it
- Systematic Review and Meta-Analysis of the Diagnostic Accuracy of a Graded Gait and Truncal Instability Rating in Acutely Dizzy and Ataxic Patients.Cerebellum (London, England) · 2024Pooled it
- Impact of Clinician Training Background and Stroke Location on Bedside Diagnostic Test Accuracy in the Acute Vestibular Syndrome - A Meta-Analysis.Annals of neurology · 2023Pooled it
- Labyrinthine hemorrhage: practical lessons from a rare cause of acute vestibular syndrome.Arquivos de neuro-psiquiatria · 2026Article
- Automated vertigo diagnosis using video-oculography and artificial intelligence for clinic-based triage: Preliminary results.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026Article
- Negative Video Head Impulse Test in Acute Vestibular Syndrome Does Not Exclude Vestibular Neuritis: Insights and Challenges in Diagnosis.Clinical case reports · 2025Article
- Diagnostic Errors in the Acutely Dizzy Patient-Lessons Learned.Brain sciences · 2025Review
- Evolution of Vestibular Findings During and Between the Attacks of Meniere Disease: Update.Neurology. Clinical practice · 2024Review
- Digital biomarkers from gaze tests for classification of central and peripheral lesions in acute vestibular syndrome.Frontiers in neurology · 2024Article
- Video head impulse test in stroke: a review of published studies.Frontiers in neurology · 2024Review
- Neurological update: neuro-otology 2023.Journal of neurology · 2023Article
- Bedside Testing in Acute Vestibular Syndrome-Evaluating HINTS Plus and Beyond-A Critical Review.Audiology research · 2023Review
- Article
- Hyperacute assessment of vertigo in suspected stroke.Frontiers in stroke · 2023Review
- Hyperacute vestibular syndrome: the role of an acute vertigo service.Frontiers in stroke · 2023Article
- Vestibular assessment in sudden sensorineural hearing loss: Role in the prediction of hearing outcome and in the early detection of vascular and hydropic pathomechanisms.Frontiers in neurology · 2023Article
- A prospective study on the application of HINTS in distinguishing the localization of acute vestibular syndrome.BMC neurology · 2022Article
- Topography and etiologies of cerebellar infarcts presenting as isolated acute vestibular syndrome.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2022Article
- Article
- Dizziness in the Emergency Department: Insights and Epidemiological Data - a Population Based Study.Maedica · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 3 institutions in 2 countries.
Funding
Abstract
Patients who present to the emergency department with symptoms of acute vertigo or dizziness are frequently misdiagnosed. Missed opportunities to promptly treat dangerous strokes can result in poor clinical outcomes. Inappropriate testing and incorrect treatments for those with benign peripheral vestibular disorders leads to patient harm and unnecessary costs. Over the past decade, novel bedside approaches to diagnose patients with the acute vestibular syndrome have been developed and refined. A battery of three bedside tests of ocular motor physiology known as "HINTS" (head impulse, nystagmus, test of skew) has been shown to identify acute strokes more accurately than even magnetic resonance imaging with diffusion-weighted imaging (MRI-DWI) when applied in the early acute period by eye-movement specialists. Recent advances in lightweight, high-speed video-oculography (VOG) technology have made possible a future in which HINTS might be applied by nonspecialists in frontline care settings using portable VOG. Use of technology to measure eye movements (VOG-HINTS) to diagnose stroke in the acute vestibular syndrome is analogous to the use of electrocardiography (ECG) to diagnose myocardial infarction in acute chest pain. This "eye ECG" approach could transform care for patients with acute vertigo and dizziness around the world. In the United States alone, successful implementation would likely result in improved quality of emergency care for hundreds of thousands of peripheral vestibular patients and tens of thousands of stroke patients, as well as an estimated national health care savings of roughly $1 billion per year. In this article, the authors review the origins of the HINTS approach, empiric evidence and pathophysiologic principles supporting its use, and possible uses for the eye ECG in teleconsultation, teaching, and triage.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.