The management of acute isolated vertigo in the emergency department: a mini review

Acute vertigo is defined as the sensation of movement of oneself or the environment in the absence of actual motion, and it represents a common reason for admission to the emergency department. This symptom is associated with high healthcare resource utilization and prolonged hospital stays. However, the diagnostic yield of brain imaging in the acute phase remains low, given the limited sensitivity of both CT and MRI in detecting central causes of vertigo. In contrast, clinical examination has proven to be highly accurate and efficient when performed by experienced clinicians. Over recent years, several clinical algorithms have been developed to improve the diagnostic accuracy of emergency physicians in evaluating patients with acute vertigo. Among these, the HINTS and STANDING algorithms have undergone external validation in emergency settings, demonstrating good diagnostic performance. The objective of this review is to provide scientific evidence to support clinical decision-making for physicians assessing adult patients presenting with acute vertigo in the emergency department.