SynthesisJournal of neurology2025
Intravenous thrombolysis in patients with acute dizziness or imbalance and suspected ischemic stroke-systematic review.
Synthesis in Journal of neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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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.
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Who cites it
4 citing papers in PubMed.
- Diagnostic challenges in posterior circulation ischemic stroke presenting with acute dizziness and vertigo.Frontiers in neurology · 2026Review
- The Challenge of Diagnosing Labyrinthine Stroke-A Critical Review.Brain sciences · 2025Review
- Usefulness of Nystagmus Patterns in Distinguishing Peripheral From Central Acute Vestibular Syndromes at the Bedside: A Critical Review.Journal of clinical neurology (Seoul, Korea) · 2025Review
- Diagnostic Errors in the Acutely Dizzy Patient-Lessons Learned.Brain sciences · 2025Review
Corrections and comments
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCorrect 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.
methodsWe performed a systematic search (MEDLINE, Embase) to identify studies reporting on acute treatment in PCS presenting as AVS/AIS (PROSPERO-registration = CRD42024537272). Key parameters were extracted. Risk of bias was assessed (Downs-and-Black quality assessment checklist).
resultsWe identified 3883 citations and included seven study cohorts (n = 1000 patients including 950 ischemic strokes). Overall, 251/1000 patients (25.1%) received IVT; EVT was performed in 46/368 (12.5%). Acute vertigo/dizziness was reported in 295/1000 (29.5%) patients. AVS criteria were met in 186/407 (45.7%) patients evaluated, and AIS criteria in 82/346 (23.7%). IVT was reported in 71/195 (36.4%) AVS/AIS patients and EVT in 13/77 (16.9%) cases, whereas the door-to-needle time (DNT) was significantly longer for PCS compared to anterior-circulation stroke (90 ± 29min vs. 74 ± 30min, p = 0.003) in one study. DNT was similar in those patients presenting with AVS/AIS compared to all PCS presentations in another study (70 ± 39min (AVS/AIS) vs. 63 ± 35min (all)). An mRS
conclusionsInsufficient data exist to drive any firm recommendation about treating otherwise eligible patients with AVS/AIS with IVT/EVT and judgments must be made on a case-by-case basis. Further research on this specific patient group is needed.
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