“The bucket test” can be helpful to distinguish central from peripheral acute vestibular syndrome - A case report

Abstract In acute vestibular syndrome (AVS), an infarct in the territory of the anterior inferior cerebellar artery (AICA) can be mistaken for a peripheral vestibular lesion. We present a case that at first showed the clinical signs of a typical peripheral origin (uni-directional nystagmus, pathological head impulse test and no skew deviation), but performed the “bucket test” non-coherent with a peripheral AVS. CT and CT-angiography failed to identify the infarction in the AICA territory that was revealed on MRI the following day. In this case the “bucket test” was the determining factor that prompted the MRI. Besides that the test might be considered in all patients presenting with AVS, it has also the great advantage of being extremely cheap to produce.