AVS is characterized by rapid onset of vertigo, nausea/vomiting, and gait unsteadiness with head motion intolerance and nystagmus. The most common cause tends to be viral in nature, affecting the inner ear. While this may be the domain of our esteemed neurology colleagues, there are 2.6 million ED visits for dizziness or vertigo annually in the United States, where the differential between a benign viral cause of vertigo or dizziness must be delineated from potentially lethal causes such as brainstem or cerebellar strokes. Vertigo and dizziness, especially in cases of labyrinthitis, is caused by inflammation along the semicircular canals, affecting the flow of fluid throughout the system and causing the brain to interpret tilt or head spinning when there is none. However, these same systems can be disrupted by central nervous pathologies that affect the vestibulocochlear nerve or the pons, which CN VIII enters. Acute stroke in the vertebrobasilar circula...