To assess the integrity of the vertebral arteries
• The patient is seated
• The examiner stands close to the patient
• The patient flexes both arms to 90 with forearms supinated. The patient is instructed to close their eyes and tip the head backward. At this point, the patient may report the presence of symptoms. If no symptoms are present, the patient is asked to rotate their head to one side and hold it. If no symptoms are reported after 30 seconds, test the other side.
• Observe the patient′s arms for drifting or general instability.
Positive if the patient reports vertigo and dizziness, or the examiner observes drifting of one of the arms. If positive, the test is stopped immediately.
Signifies compromised arterial supply to the brainstem implicating the vertebral arteries. Also consider the possibility of vestibular disease.