J Stroke.  2014 Sep;16(3):124-130. 10.5853/jos.2014.16.3.124.

Isolated Vascular Vertigo

• Lee H

• KMID: 2223697
• DOI: http://doi.org/10.5853/jos.2014.16.3.124

Abstract

Strokes in the distribution of the posterior circulation may present with vertigo, imbalance, and nystagmus. Although the vertigo due to a posterior circulation stroke is usually associated with other neurologic symptoms or signs, small infarcts involving the cerebellum or brainstem can develop vertigo without other localizing symptoms. Approximately 11% of the patients with an isolated cerebellar infarction present with isolated vertigo, nystagmus, and postural unsteadiness mimicking acute peripheral vestibular disorders. The head impulse test can differentiate acute isolated vertigo associated with cerebellar strokes (particularly within the territory of the posterior inferior cerebellar artery) from more benign disorders involving the inner ear. Acute audiovestibular loss may herald impending infarction in the territory of anterior inferior cerebellar artery. Appropriate bedside evaluation is superior to MRIs for detecting central vascular vertigo syndromes. This article reviews the keys to diagnosis of acute isolated vertigo syndrome due to posterior circulation strokes involving the brainstem and cerebellum.

Keyword

Isolated vertigo; Stroke; Vascular cause; Acute vestibular syndrome; Cerebellum; Brainstem

MeSH Terms

Arteries
Brain Stem
Cerebellum
Diagnosis
Ear, Inner
Head Impulse Test
Humans
Infarction
Magnetic Resonance Imaging
Neurologic Manifestations
Stroke
Vertigo*