Execution:
- Patient is in supine position with his head over the edge of the table
- The examiner supports the patient’s head, rotates it submaximally to one side and brings it into extension
- This position is held for 30 seconds, while the examiner is talking to the patient or the patient is asked to count
- Afterwards, the patient’s head is brought back to neutral position and is closely watched for symptoms by the examiner for another 30 seconds
Positive Outcome: The patient displays signs of brain ischemia like diplopia, dysphagia, dysarthria, drop attacks, dizziness, nausea, numbness in the face and/or nystagmus
|
Study |
Reliability | Sn | Sp | LR+ |
LR- |
| Hutting et al. (2013) |
NA |
0-57 | 67-100 | 0.21-83.25 |
1.40-0.81 |
| Comment: The ipsilateral vertebral artery is tested for its ability to compensate blood flow to the brain as the vertebral artery in the opposite direction of rotation is compressed. The extension component decreases blood flow in through the internal carotid artery. |
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