HINTS / HINTS-plus (vestibular exam)
HINTS / HINTS-plus exam (Kattah 2009) for acute vestibular syndrome.
Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.
Example
- Head-impulse test
- Normal / untestable -- no corrective saccade (central)
Result: HINTS exam: a central (stroke) pattern -- normal head impulse -- concerning for a central cause; the imaging decision stays with the clinician and local protocol.
The tool opens with these values already filled in. Replace them with your own.
What the result means
- Peripheral (benign)
- all three reassuring: an abnormal head impulse (saccade present), direction-fixed nystagmus, and no skew (and no new hearing loss).
- Central (stroke)
- any one central feature -- a normal head impulse, direction-changing nystagmus, a skew, or new hearing loss (HINTS-plus) -- flags a central cause.
What you enter
- Head-impulse test (abnormal = peripheral, normal = central)
- Nystagmus (fixed = peripheral, direction-changing = central)
- Skew deviation (present = central)
- New unilateral hearing loss (HINTS-plus)
How this is calculated
Kattah JC, Talkad AV, Wang DZ, Hsieh YH, Newman-Toker DE. HINTS to diagnose stroke in the acute vestibular syndrome: three-step bedside oculomotor examination more sensitive than early MRI DWI. Stroke. 2009;40(11):3504-3510. Read the source ↗
A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.