Providing diagnostic accuracy in acute onset, continuous dizziness.
- Conditions
- Acute vestibular syndrome. Vertebrobasilar/cerebellar stroke. Peripheral vestibular syndrome.
- Registration Number
- NL-OMON21345
- Lead Sponsor
- Haaglanden Medical Center
- Brief Summary
Not available
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Pending
- Sex
- Not specified
- Target Recruitment
- 800
Acute onset, continuous dizziness, still present at arrival on the ED;
- Presentation within 24 hours after onset of dizziness;
- Age 18 years or older.
- Clear signs of benign paroxysmal positional vertigo (BPPV) (i.e. acute onset, continuous dizziness successfully treated by canalith repositioning);
- A history of recognizable recurrent vertigo or acute onset, continuous dizziness compatible with Meniere’s disease or vestibular migraine;
- Deficits upon neurological examination other than a nystagmus (i.e. ataxia (gait imbalance is allowed), dysarthria, spontaneous skew deviation, gaze palsy or lowered state of consciousness (i.e. EMV <14));
- Pregnancy at the time of inclusion;
- Known contra-indication for MRI (e.g. claustrofobia, non MRI-compatible pacemaker or ICD);
- Clear medical condition other than stroke (central) or non-stroke (peripheral) vestibular disorder that explains acute onset, continuous dizziness. Examples are hypotension, sepsis, medication related;
- Previous inclusion in study;
- No informed consent;
- Unable to undergo follow up (e.g. life expectancy <3 months, severe cognitive impairment, no permanent residence in the Netherlands);
- Insufficient command of the Dutch language.
Study & Design
- Study Type
- Observational non invasive
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method Final diagnosis (stroke or peripheral) 3 months after inclusion.
- Secondary Outcome Measures
Name Time Method - Healthcare costs (costs related to days of admission, costs of MRI/CT scans).<br>- Resource use measurement during 3 months follow-up. <br>- Quality Adjusted Life Years during 3 months follow-up.<br>- Sensitivity/specificity of MRI DWI of the brain within 24 hours.<br>- Sensitivity/specificity of MRI DWI of the brain after 72 hours.<br>- Sensitivity/specificity of the clinical gestalt” of the doctor.<br>- Differences in sensitivity/specificity of the HINTS+ examination between neurologists/neurology residents and ED physicians/ED residents.<br>- Incidence of acute onset, continuous dizziness (and proportion of stroke) in Dutch ED population.