Hanna J, et al. - In the present study, the researchers compared the use of images between patients with vertigo and dizziness (VDS) diagnosed with stroke and benign paroxysmal positional vertigo (BPPV) presenting at the emergency department (ED). All individuals presenting to the ED with VDS (January 2014–June 2018) were identified and those with a discharge diagnosis of stroke and BPPV were evaluated. Seventeen thousand eight hundred eighty-four individuals presented to with VDS. The authors discovered that the utilization of imaging in BPPV patients with VDS was high. The image-receiving profile of patients with BPPV was significantly more benign than that of patients with stroke (a quarter had no neurologic symptoms, exam findings, or stroke RFs). The HINTS (head impulse, nystagmus, skew) examination was underused and, despite well-established limitations in the diagnosis of posterior circulation strokes, computed tomography was heavily used. This research illustrates the need for increased HINTS test practice, narrowing computed tomography scope, and a higher threshold for isolated VDS imaging patients.