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Acute Vertigo

Urgent

Acute vertigo is high yield because posterior circulation stroke can mimic benign vestibular disease. The challenge is distinguishing BPPV and vestibular neuritis from cerebellar or brainstem pathology.

Red flags

  • New focal neurological deficit or severe gait inability
  • Direction-changing nystagmus or central HINTS features
  • Headache, neck pain, or vascular risk factors with sudden onset
  • New hearing loss or severe persistent vomiting/dehydration

Common causes to keep in the differential

BPPV
Vestibular neuritis
Posterior circulation stroke
Labyrinthitis
Vestibular migraine

Linked MedVellum pathways

Acute vertigo

Urgent

Main vertigo differential and emergency workup.

Open topic

BPPV

Common

Benign positional vertigo patterns and treatment manoeuvres.

Open topic

Stroke search

Emergency

Jump into stroke-related topics from the search surface.

Open topic

Next practical steps

  • Use the acute vertigo page as the main diagnostic frame.
  • Look for central signs early and escalate when stroke is plausible.

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Use MedVellum search when the presentation is mixed, atypical, or you need a broader differential before narrowing into a topic page.

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