HINTS to diagnose posterior circulation stroke
Research type
Research Study
Full title
HINTS to diagnose posterior circulation stroke in patients with acute vertigo
IRAS ID
324423
Contact name
Nehzat Koohi
Contact email
Sponsor organisation
University College London Hospital
Duration of Study in the UK
2 years, 5 months, 2 days
Research summary
Background:
‘Vertigo’ or ‘dizziness’ is a common symptom of many conditions including a life-threatening brain disorder, such as stroke. Dangerous strokes, presenting as vertigo, are often missed; they are difficult to detect by doctors and, in the first 24 hours, might not be seen on a brain scan. Early stroke treatment can save lives and avoid serious long-term disabilities. So, it is crucial to tell immediately when people with vertigo are having a stroke.
Research shows a non-invasive bedside test, called HINTS-plus (Head Impulse, Nystagmus, Test of Skew, plus hearing test) is better at detecting a stroke in patients with vertigo than an early brain scan. The problem is that only specialists in eye movements can understand the test results. Our recent survey showed that many UK emergency stroke clinicians reported low confidence in interpreting the HINTS-plus test. The test’s value in the emergency stroke setting is unknown.
Study design (stage 2, current ethics application):
After training the emergency clinicians (stage 1), I will study 260 dizzy patients. The trained clinicians will perform the HINTS-plus test on these patients. All patients will undergo a brain scan 24-72 hours after their first symptom and a specialist will then confirm the final diagnosis.
I will also use video goggles to record and interpret eye movements. The automated
HINTS-plus test will be done in the same patients, and I will compare the results of this system with the HINTS-plus results as performed by the trained practitioners. This
way, we will find out which is the best approach to detect a stroke.REC name
London - Brent Research Ethics Committee
REC reference
23/PR/0112
Date of REC Opinion
16 Mar 2023
REC opinion
Further Information Favourable Opinion