Case · Clinician · AICA territory / HINTS-plus
Acute vertigo with new unilateral deafness
61-year-old man, hypertension, smoker.
Vignette
A 61-year-old man presents with 4 hours of severe vertigo and sudden right-sided deafness with tinnitus. He also reports right-sided facial numbness and clumsiness of the right hand. He has hypertension and is a current smoker.
Diagnostic question
How would you classify the HINTS pattern and act on it?
Teaching point
The peripheral HINTS triad does not exclude AICA stroke. When new acute sensorineural hearing loss accompanies acute vestibular syndrome — HINTS-plus is positive — the patient needs urgent posterior-fossa imaging regardless of how reassuring the three core HINTS findings appear.