Video Head Impulse Test (vHIT)

A modern, non-invasive diagnostic tool that objectively measures the vestibulo-ocular reflex (VOR) in response to rapid head movements, assessing semicircular canal function—especially valuable for identifying vestibular contributions to post-concussion dizziness and imbalance.

Concussions can impair the VOR, causing gaze instability during head motion. vHIT uses high-speed video goggles to record eye movements while the clinician delivers quick, unpredictable head impulses, quantifying VOR gain and detecting corrective saccades at high frequencies (150–300°/s).

Key aspects evaluated include:

• VOR gain (eye velocity relative to head velocity)
• Overt and covert corrective saccades
• Symmetry across left/right sides and all six semicircular canals
• Function in horizontal, LARP (left anterior–right posterior), and RALP planes

vHIT is performed in two primary contexts:

1. Diagnostic Evaluation — Identifies peripheral vestibular deficits contributing to persistent dizziness or imbalance after head injury.
2. Progress Monitoring — Tracks VOR recovery during vestibular rehabilitation or concussion management.

The test takes 10–20 minutes, uses lightweight goggles while focusing on a target, and is safe/tolerable for most patients (mild transient dizziness possible). It is a key objective tool in comprehensive care, combined with other vestibular assessments and clinical judgment.

Benefits of Video Head Impulse Test (vHIT)

• Quantifies high-frequency VOR function for each semicircular canal
• Detects subtle deficits (including covert saccades) missed by bedside testing
• Quick, repeatable, and more patient-friendly than caloric irrigation
• Helps differentiate peripheral vs. central vestibular issues
• Guides targeted rehab and supports return-to-activity decisions

vHIT is trusted in concussion clinics, neurotology, sports medicine, and vestibular rehab programs as an advanced tool for precise vestibular assessment.

If you're experiencing dizziness, imbalance, or visual issues after a head injury, discuss vHIT with one of our providers today.

Contact our office to schedule

For more information, explore resources from Interacoustics or specialized vestibular and concussion programs.