EBQ:HINTS Exam - Revision history

Danbot: Added Criticisms section

2026-03-21T23:06:10Z

Added Criticisms section

← Older revision		Revision as of 23:06, 21 March 2026
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	*Perry et al. Prospective validation of the ABCD2 score for patients in the emergency department with transient ischemic attack. CMAJ July 12, 2011 vol. 183 no. 10.		*Perry et al. Prospective validation of the ABCD2 score for patients in the emergency department with transient ischemic attack. CMAJ July 12, 2011 vol. 183 no. 10.

			==Criticisms==
			*Small, single-center study (n=101) limits generalizability
			*HINTS requires expertise in performing and interpreting the head impulse test, which many emergency physicians lack
			*Sensitivity of 100% may not be reproducible in general ED practice by non-neurologists
			*The study only included patients with acute vestibular syndrome; does not apply to episodic vertigo (BPPV)
			*Video head impulse testing (vHIT) may be more reliable than bedside testing but requires additional equipment
			*False negatives may occur in small cerebellar or lateral medullary strokes

	==Funding==		==Funding==

2026-03-21T23:01:10Z

Added Major Points, Population, and Outcomes content

← Older revision		Revision as of 23:01, 21 March 2026
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	*Study period: 2003-2007		*Study period: 2003-2007
	*Bedside HINTS examination (Head Impulse, Nystagmus, Test of Skew) compared to MRI with diffusion-weighted imaging as gold standard		*Bedside HINTS examination (Head Impulse, Nystagmus, Test of Skew) compared to MRI with diffusion-weighted imaging as gold standard

			==Population==
			===Inclusion Criteria===
			*Adults presenting with acute vestibular syndrome (acute sustained vertigo with nystagmus, head motion intolerance, nausea/vomiting, gait unsteadiness)
			*Symptom onset within 24 hours
			===Exclusion Criteria===
			*Episodic vertigo (BPPV)
			*Known peripheral cause of vertigo
			*Unable to cooperate with HINTS examination

	==Inclusion Criteria==		==Inclusion Criteria==

2026-03-21T22:42:28Z

Added Study Design section

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	==Major Points==		==Major Points==
	{{HINTS Exam Procedure}}		{{HINTS Exam Procedure}}

			==Study Design==
			*Prospective, cross-sectional study
			*Single academic medical center (Johns Hopkins Hospital)
			*N = 101 patients with acute vestibular syndrome
			*Study period: 2003-2007
			*Bedside HINTS examination (Head Impulse, Nystagmus, Test of Skew) compared to MRI with diffusion-weighted imaging as gold standard

	==Inclusion Criteria==		==Inclusion Criteria==

2019-12-01T11:46:53Z

External Links

← Older revision		Revision as of 11:46, 1 December 2019
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	==External Links==		==External Links==
	*[http://emcrit.org/misc/posterior-stroke-video/ HINTS Exam Demonstration]		*[http://emcrit.org/misc/posterior-stroke-video/ HINTS Exam Demonstration]
	*http://content.lib.utah.edu/cdm/singleitem/collection/ehsl-dent/id/6		*[http://content.lib.utah.edu/cdm/singleitem/collection/ehsl-dent/id/6 Video on HINTS Exam]
			*[https://www.youtube.com/watch?v=VwmrjYuvqtQ&feature=emb_title Another Video on HINTS Exam]

	==See Also==		==See Also==

2018-11-04T07:45:07Z

2016-02-18T03:00:03Z

Inclusion Criteria

← Older revision		Revision as of 03:00, 18 February 2016
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	==Inclusion Criteria==		==Inclusion Criteria==
	At least one stroke risk factor:		At least one stroke risk factor:
	*~~atrial~~ fibrillation		*[[Atrial fibrillation]]
	*~~diabetes~~		*[[Diabetes]]
	*~~eclampsia~~		*[[Eclampsia]]
	*~~hypercoagulable~~ state		*Hypercoagulable state
	*~~hyperlipidemia~~		*Hyperlipidemia
	*~~hypertension~~		*Hypertension
	*~~prior~~ stroke or myocardial infarction.		*Prior stroke or myocardial infarction.
	*~~recent~~ cervical trauma		*Recent cervical trauma
	*~~smoking~~		*Smoking

	==Exclusion Criteria==		==Exclusion Criteria==

2016-02-18T02:06:55Z

2016-02-18T02:02:19Z

alphabetical inclusion criteria (easier to read)

← Older revision		Revision as of 02:02, 18 February 2016
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	==Inclusion Criteria==		==Inclusion Criteria==
	At least one stroke risk factor: ~~smoking, hypertension, diabetes, hyperlipidemia,~~ atrial fibrillation, eclampsia, hypercoagulable state~~, recent cervical trauma,~~ prior stroke or myocardial infarction.		At least one stroke risk factor:
			*atrial fibrillation
			*diabetes
			*eclampsia
			*hypercoagulable state
			*hyperlipidemia
			*hypertension
			*prior stroke or myocardial infarction.
			*recent cervical trauma
			*smoking

	==Exclusion Criteria==		==Exclusion Criteria==

2015-10-31T20:29:00Z

Criticisms

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	===Subgroup analysis===		===Subgroup analysis===

	==~~Criticisms~~==		==Further Discussion==
	'''This was performed in an outpatient setting by neuro ophthalmologists not emergency physicians and may not be generalizable to an ED population		'''This was performed in an outpatient setting by neuro ophthalmologists not emergency physicians and may not be generalizable to an ED population
	'''		'''

2014-11-03T16:15:11Z

External Links

← Older revision		Revision as of 16:15, 3 November 2014
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	*[http://emcrit.org/misc/posterior-stroke-video/ HINTS Exam Demonstration]		*[http://emcrit.org/misc/posterior-stroke-video/ HINTS Exam Demonstration]
	*http://content.lib.utah.edu/cdm/singleitem/collection/ehsl-dent/id/6		*http://content.lib.utah.edu/cdm/singleitem/collection/ehsl-dent/id/6

			==See Also==
			[[Vertigo]]

	==Sources==		==Sources==