Repetitive Episodic Isolated Vertigo in a Patient with Cerebellar Infarction

J Stroke Cerebrovasc Dis. 2019 Jul;28(7):e98-e99. doi: 10.1016/j.jstrokecerebrovasdis.2019.03.051. Epub 2019 Apr 20.

Abstract

Isolated vertigo is an important symptom of posterior circulation stroke. It has been reported that 11.3% of patients with isolated vertigo have a stroke and that most lesions are located in the cerebellum, particularly in the posterior inferior cerebellar artery. We report the case of a 63-year-old man with multiple atherosclerotic risk factors and atrial fibrillation who showed repeated episodes of isolated vertigo. His repeated vertigo was short-lasting and was often triggered by body position, mimicking benign paroxysmal positional vertigo. Cranial computed tomography on the third hospital day showed left cerebellar infarction within the territory of the posterior inferior cerebellar artery. The vertigo was ameliorated on the fifth hospital day and warfarin was prescribed for secondary prevention. Clinicians should pay special attention to cases in which a patient presents isolated vertigo, even if it shows transient recurrence or is triggered by a positional change, especially in patients with multiple cerebrovascular risk factors.

Keywords: Isolated vertigo—cerebellar infarction—positional vertigo—CPPV.

Publication types

  • Case Reports

MeSH terms

  • Anticoagulants / therapeutic use
  • Brain Infarction / complications*
  • Brain Infarction / diagnostic imaging
  • Brain Infarction / drug therapy
  • Cerebellar Diseases / complications*
  • Cerebellar Diseases / diagnostic imaging
  • Cerebellar Diseases / drug therapy
  • Cerebral Angiography / methods
  • Computed Tomography Angiography
  • Humans
  • Male
  • Middle Aged
  • Postural Balance*
  • Posture*
  • Recurrence
  • Secondary Prevention / methods
  • Treatment Outcome
  • Vertigo / diagnosis
  • Vertigo / etiology*
  • Vertigo / physiopathology
  • Vertigo / prevention & control
  • Warfarin / therapeutic use

Substances

  • Anticoagulants
  • Warfarin