Introduction
Patients presenting with dizziness comprise about 4% of all emergency department presentations. Our role is to exclude central causes. To be able to do this we an approach that allows us to differentiate central from peripheral causes of dizziness. The diagnosis is far from straightforward and emergency physicians can miss up to one third of strokes in patients presenting with dizziness (1).
The most common causes (up to 43%) of vertigo are benign peripheral disorders. Central causes are usually posterior circulation strokes, comprising 20% of all ischaemic strokes. The posterior circulation comprises the Vertebral, Basilar and the Posterior Cerebral Arteries and their branches. This vertebrobasilar system supplies the brainstem, midbrain, cerebellum, thalamuses and areas of the parietal and occipital cortex and it is the shared neurovascular supply, that results in peripheral and central causes presenting similarly.