ArticleJournal of neurology2018
Early MRI-negative posterior circulation stroke presenting as acute dizziness.
Article in Journal of neurology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 4 of them syntheses that pooled it.
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Who cites it
24 citing papers in PubMed, 4 syntheses or guidelines pooled it, 43 citations in OpenAlex.
- The Epidemiology and Clinical Presentation of the Acute Imbalance Syndrome (AIS)-A Systematic Review and Meta-Analysis.European 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
- Head impulse, nystagmus, and test of skew examination for diagnosing central causes of acute vestibular syndrome.The Cochrane database of systematic reviews · 2023Pooled it
- Systematic review and meta-analysis of the diagnostic accuracy of spontaneous nystagmus patterns in acute vestibular syndrome.Frontiers in neurology · 2023Pooled it
- Imaging suspected posterior circulation stroke in the emergency department: a practical modality-based review.Emergency radiology · 2026Review
- Diagnostic challenges in posterior circulation ischemic stroke presenting with acute dizziness and vertigo.Frontiers in neurology · 2026Review
- Timing and outcome prediction of intravenous thrombolysis in posterior circulation stroke: Insights from the Austrian Stroke Unit Registry.European stroke journal · 2026Observational
- Identifying tests to evaluate in a diagnostic accuracy study for patients with vertigo in general practice: a Delphi study.BMC primary care · 2025Article
- Vestibular event monitoring in acute posterior circulation stroke: from emergency room to stroke unit and beyond.Journal of neurology · 2025Article
- Dorsolateral pontine lesions produce distinct ocular motor abnormalities with anatomical correlations.European journal of neurology · 2025Article
- Homocysteine, HHcy, H-type hypertension and dizziness: an NHANES analysis.Frontiers in neurology · 2025Article
- Progress in the Study of Diagnostic Methods for Central Acute Vestibular Syndrome of a Vascular Cause.International journal of general medicine · 2025Review
- Enhancing Stroke Recognition: A Comparative Analysis of Balance and Eyes-Face, Arms, Speech, Time (BE-FAST) and Face, Arms, Speech, Time (FAST) in Identifying Posterior Circulation Strokes.Journal of clinical medicine · 2024Article
- Wake-Up Thrombolysis With Negative Diffusion-Weighted Magnetic Resonance Imaging.Journal of medical cases · 2024Article
- Optimal CT perfusion thresholds for core and penumbra in acute posterior circulation infarction.Frontiers in neurology · 2023Article
- Hyperacute vestibular syndrome: the role of an acute vertigo service.Frontiers in stroke · 2023Article
- Patterns of ischemic posterior circulation strokes: A clinical, anatomical, and radiological review.International journal of stroke : official journal of the International Stroke Society · 2022Review
- What guides decision-making on intravenous thrombolysis in acute vestibular syndrome and suspected ischemic stroke in the posterior circulation?Journal of neurology · 2021Article
- The spectrum of acute vestibular neuropathy through modern vestibular testing: A descriptive analysis.Clinical neurophysiology practice · 2021Article
- Modern machine-learning can support diagnostic differentiation of central and peripheral acute vestibular disorders.Journal of neurology · 2020Article
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The aim of this study was to determine the frequency, clinical and radiological features, and efficacy of clinical evaluation and perfusion-weighted imaging (PWI) for the prediction of final stroke in patients with DWI/MRI-negative posterior circulation stroke (PCS) presenting acute dizziness/vertigo. From our comprehensive prospective stroke registry of acute ischemic stroke during a 7-year period, we identified 1846 consecutive patients with PCS, 850 of whom presented with acute dizziness/vertigo. Of these 850 patients, initial DWI-MRI was negative in 35 (4.1%). In these 35 patients, dizziness/vertigo was acute prolonged in 31 and recurrent transient in 4. Focal neurological signs or profound imbalance were present in 16/35 or 18/34, respectively. Spontaneous nystagmus was absent in 21/35; the HINTS protocol (head impulse, nystagmus, and test-of-skew) was not applicable to them. In 12/26 patients, PWI was positive and the same time as DWI was negative. The usual site of lesion was the lateral medulla (n = 18). Twenty-nine patients (83%) had small strokes, while 19 (54%) had large vessel strokes. The sensitivity of systematic clinical evaluation adopting neurological examination, HINTS plus, and assessment of equilibrium was 83%, for prediction of final stroke and 100% when combined with PWI. An integrated approach using systematic neurological and neuro-otological examinations combined with PWI accurately diagnoses PCS presenting with acute dizziness/vertigo. Although most patients with acute vertigo and MRI-negative PCS have small brainstem strokes, about a half have large vessel stroke with greater risk of progression requiring prompt treatment.
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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.